50 Shades of New Hope for Stroke Detection

As we already know stroke is the third biggest cause of death in the western world. It occurs when the supply of blood to the brain is cut off or disturbed either by a blockage, or a bleed causing

part of the brain to die off. Each year in the U.K., there will be almost 50,000 people with brain attacks: one third of those will not survive, one third will be left severely disabled and about one third will make some kind of recovery. We know only too well how real this situation is. In the time it will take to read this blog, approximately nine people of all ages in the U.K. will be affected by stroke. This is why I feel so passionate about doing my talks to help raise greater awareness to help to prevent those strokes that we now know can be prevented.

Our brain is a far more complex organ than the heart; it technically operates our whole body and every organ within it. Although strokes are common exactly why they occur is far from straightforward.

Again, as we are well aware for anyone who experiences the first sign of a stroke speed is vital; the FAST message is something that must be acted upon by all. The key to the best recovery is rapid recognition of the attack followed by prompt treatment.

Once at hospital medics are also faced with the dilemma of strokes that may present themselves as what is known as ‘mimics’. They show typical symptoms of stroke, but can turn out to be a severe migraine, what are they to do? There are some strokes which are really obvious and easily diagnosed by the scan, but there are also strokes where the brain scan shows nothing even though all symptoms are present

Especially in the present NHS cash-strapped situation what would the answer be? They run the risk of not treating and the patient later suffers disability or worse. Or they do treat and it perhaps was not a stroke?! It is a tough call.

The challenge of stroke diagnosis is something that as long as twenty years ago began to intrigue a Scottish neurologist called Nicholas Dale. He takes up the story of when the symptoms are all there yet the scan does not show anything. This is not uncommon. How many of us, or people we know, had this?

The guardian newspaper published a story describing how twenty years on Dale has come up with an idea for a sensor, about the size of a thumbnail: the smart chip.

After a series of nationwide clinical trials Dale and the biosensor company, Sarissa, which is an offshoot of Warwick University are now on the brink of an incredible breakthrough in stroke diagnosis.

He first used this sensor to measure tadpoles swimming and felt it had to have other uses. Little did he know it would change his life and the lives of many others too altering their fate. He worked with Bruno Frenguelli from Scotland, they later met to discuss how exactly they needed to progress further to find the perfect missing piece of this jigsaw; Llaudet, a Spanish organic chemist. He was fantastic with polymers that were exactly what was required to make tiny biosensors. From then an 8 year partnership began, originally funded by a local seed charity and later by the Wellcome Trust. They worked at creating a tiny biosensor which was the ancestor of the now Sarissa smart chip. Obviously, as would be expected there were set backs, let downs and fails but they did not give up.

In 2004, they hit a brick wall. Dale said he soon realised that the middle aged white men with the purse strings were not interested. Dale returned to looking at blood and identified the release of purines. He began to probe that at the onset of stroke, the level of purines released is detectable; a high purine reading immediately indicates a stroke. Despite negative reaction, the committee decided to take a chance on his smart chip three years ago.

Professor Christine Roffe who is at the forefront of stroke research in the U.K. has been trialing Sarissa’s chip in Stokes Acute Stroke unit since 2014. She confirms that the first problem in A&E is diagnosis and explains that she recently had a patient who had all the symptoms of stroke but turned out to be suffering from migraine and adds that one third of symptomatic stroke patients are ‘mimics’.  She explains it is vital to treat strokes within four hours, however this does not always happen, as people often do not phone paramedics quickly enough. They say at first the smart chip was a bit hit and miss, but now it is a state of the art device with impressive results. By April this year, all findings will be collated and presented to the National Institute for Health Research. I for one hope it is passed and accepted fully.  I think it sounds fascinating and wish it was trialed in more stroke units already, what do you think? Perhaps also by using this more strokes would be identified in younger people quicker too do you agree? They are often regarded drunk.

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