A drug that breaks up blood clots in the brains of stroke patients could be used more widely than at present without increased risk, a brain scan study suggests.
It had previously been thought that giving the drug to people with signs of early damage in the brain caused by a stroke would increase the chances of them suffering a bleed on the brain - which can be fatal.
The study is the first to show that early tissue damage seen in brain scans does not necessarily indicate an increased risk of bleeding. Patients with early tissue damage from strokes are less likely to make a full recovery, but they still benefit from receiving the drug, researchers say.
The drug - called alteplase - is the only treatment for stroke caused by a blocked blood vessel in the brain.
Worries over the appearance of brain scans of patients taken on arrival at hospital to diagnose strokes have probably meant patients who could have benefitted from alteplase did not receive it, the team says.
Experts were concerned that patients with early brain tissue damage - which can be difficult for stroke doctors to see - were more likely to suffer a brain bleed if they were treated with alteplase.
Researchers at the University of Edinburgh found there is only an increased risk of haemorrhage in patients with multiple signs of tissue damage caused by other diseases before the stroke - which are easily identified in scans - together with signs of a fresh clot blocking an artery.
In the small number of people with signs of both previous tissue damage and a new clot in a blood vessel, 14 per cent of those given alteplase are likely to have a haemorrhage, the team says. However, in people without these signs only three per cent are expected to suffer a bleed if they are given the drug.
Researchers analysed more than 3,000 people involved in a clinical trial assessing the effectiveness of alteplase as a stroke treatment.
Patient risk factors are easy to identify in brain scans, enabling doctors to decide whether the risk to patients outweighs the potential benefits of receiving alteplase, the team says.
The study, published in the journal The Lancet Neurology, was funded by the Medical Research Council.
Professor Joanna Wardlaw, of the University of Edinburgh's Centre for Clinical Brain Sciences, who led the study, said: "Bleeding in the brain is the main side effect of alteplase, so if we can avoid that hazard, then patients are more likely to benefit. Previous studies have not looked at pre-existing signs of damage nor considered analysing multiple signs in combination, yet having multiple and old signs are both very common in patients with stroke."
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A drug that breaks up blood clots in the brains of stroke patients could be used more widely than at present without increased risk, a brain scan study suggests.
It had previously been thought that giving the drug to people with signs of early damage in the brain caused by a stroke would increase the chances of them suffering a bleed on the brain - which can be fatal.
The study is the first to show that early tissue damage seen in brain scans does not necessarily indicate an increased risk of bleeding. Patients with early tissue damage from strokes are less likely to make a full recovery, but they still benefit from receiving the drug, researchers say.
The drug - called alteplase - is the only treatment for stroke caused by a blocked blood vessel in the brain.
Worries over the appearance of brain scans of patients taken on arrival at hospital to diagnose strokes have probably meant patients who could have benefitted from alteplase did not receive it, the team says.
Experts were concerned that patients with early brain tissue damage - which can be difficult for stroke doctors to see - were more likely to suffer a brain bleed if they were treated with alteplase.
Researchers at the University of Edinburgh found there is only an increased risk of haemorrhage in patients with multiple signs of tissue damage caused by other diseases before the stroke - which are easily identified in scans - together with signs of a fresh clot blocking an artery.
In the small number of people with signs of both previous tissue damage and a new clot in a blood vessel, 14 per cent of those given alteplase are likely to have a haemorrhage, the team says. However, in people without these signs only three per cent are expected to suffer a bleed if they are given the drug.
Researchers analysed more than 3,000 people involved in a clinical trial assessing the effectiveness of alteplase as a stroke treatment.
Patient risk factors are easy to identify in brain scans, enabling doctors to decide whether the risk to patients outweighs the potential benefits of receiving alteplase, the team says.
The study, published in the journal The Lancet Neurology, was funded by the Medical Research Council.
Professor Joanna Wardlaw, of the University of Edinburgh's Centre for Clinical Brain Sciences, who led the study, said: "Bleeding in the brain is the main side effect of alteplase, so if we can avoid that hazard, then patients are more likely to benefit. Previous studies have not looked at pre-existing signs of damage nor considered analysing multiple signs in combination, yet having multiple and old signs are both very common in patients with stroke."
Explore further: New drug treatment could offer stroke survivors better outcomes
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New drug treatment could offer stroke survivors better outcomes
Promising results for a new drug treatment for ischaemic stroke patients have been published today in the journal Lancet Neurology.
Use of anti-clotting drug more than three hours after stroke should be re-evaluated, say researchers
Advice to use the anti-clotting drug alteplase more than three hours after an acute stroke should be re-evaluated, say researchers writing in The BMJ this week.
New stroke prevention efforts may be paying off
(HealthDay)—Fewer people are being treated in U.S. emergency rooms for strokes caused by blood clots in the brain, which experts read as a sign that current stroke prevention methods are working.
A brighter future after stroke
There's a stroke every 10 minutes in Canada. Of those, about 10-15 per cent are triggered by arterial ruptures and uncontrolled bleeding in the brain, and are incredibly devastating. These are the strokes ...
Meta-analysis shows that alteplase given promptly after stroke reduces long-term disability
Many more stroke patients could benefit from thrombolytic treatment (the use of drugs to break up or dissolve blood clots), but it needs to be administered as quickly as possible after the first signs of ...
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Why some people hear colour, taste sounds
Researchers at The Australian National University (ANU) have shed new light on synesthesia - the effect of hearing colours, seeing sounds and other cross-sensory phenomena.
Delicate magnolia scent activates human pheromone receptor
The question if humans can communicate via pheromones in the same way as animals is under debate. Cell physiologists at the Ruhr-Universität Bochum have demonstrated that the odorous substance Hedione activates the putative ...
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Inspiration came to engineering professor Mike Noseworthy while listening to the radio.
Study deciphers the noise in the human brain
By directly recording electrical activity from the human brain, neuroscientists at the Stanford University School of Medicine have shown that distinct, distant groups of brain areas that support memory retrieval ...
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A slow, depolarizing electrical wave – sometimes called a "brain tsunami" – may be the hidden cause of sudden unexpected death in epilepsy, a disorder that kills as many as 4,000 people in the United ...
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