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Stopping Strokes

Stopping strokes

A quick test would help physicians triage patients so the right people get the right treatment at the right time

A mini stroke, called a transient ischemic attack (TIA), is a medical emergency that occurs when the blood flowing to your brain stops for a short time. One side of your body might suddenly feel weak or you may have trouble speaking or understanding what people are saying to you. The good news is that a TIA usually causes no permanent damage and, in fact, could be the proverbial cloud with a silver lining because it gives a patient the opportunity to stave off a potential full-blown stroke by seeking immediate medical attention. The glitch is there is no fast and easy means of differentiating the 50,000 Canadians arriving at emergency departments every year with actual TIAs, from an equal number who show up with symptoms mimicking TIAs — from, for example, migraines. The latter may be subjected to unwarranted, and costly, radioimaging; the former, sent home without appropriate diagnostic tests or treatment.

“The unfortunate truth is that we’re not really doing a very good job managing minor strokes,” says Victoria-based neurologist Dr. Andrew Penn. “The brain is the last frontier.” In just a few years, however, hospitals on Vancouver Island hope to be able to diagnose TIAs much the same way they do heart attacks, thanks to a personalized-health research project led by Dr. Penn and supported by a $10-million investment from Genome Canada, Genome BC, the Vancouver Island Health Authority, and four other partners. A multidisciplinary team of scientists is evaluating some 100 proteins using mass spectrometry to determine which have the strongest links to strokes; if successful, clinicians will assess the resulting multi-protein blood test and accompanying decision-aid software with TIA patients in Victoria and Calgary. It is hoped that once physicians across Canada gain access to this quick, inexpensive technology, it could be expected to avert 4,000 strokes a year, and save $210 million in direct health-care costs alone.