Discrimination between bleeding and ischaemic stroke

Contributed by

Homann Clemens

Authors

Martin Leahy

Abstract

TPA is a potent clot-busting drug that helps some people who have had a stroke recover more fully restoring blood flow in the brain, and reducing or preventing the risk of permanent damage. However, tPA cannot be given to patients experiencing a haemorrhagic stroke as it will increase bleeding and compromise or kill the patient. Its use also carries a 1-in-15 risk of causing intracranial haemorrhage (bleeding) that can be fatal if administered to the wrong patient. Nearly 10 years after its approval by the FDA, tPA is still only used in about 10% of patients eligible to receive it, and in about 2% of all stroke patients. The most promising technology to fill the need for fast, safe, accessible and relatively inexpensive discrimination between bleeding and ischaemic stroke is photoacoustic tomography PAT. It merges the advantages of light (molecular specificity, safety of non-ionising radiation and resolution) with those of ultrasound allowing us to break the diffusion (scattering) barrier facilitating imaging deep enough to determine whether there is a diagnostic subarachnoid blood pool. Thus we propose the construction of a system capable of imaging the subarachnoid space using a novel laser currently being built specifically for PAT.

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