The current diagnosis and treatment of acute strokes require speed. The treatment — using tPA as a clot-buster — must occur within three or four hours of the onset of stroke symptoms. And the treatment can’t occur until a CT of the brain shows that the stroke is embolic (ischemic), rather than hemorrhagic, because if it is the latter the tPA treatment could result in additional bleeding and further brain damage.

The difficulty in this approach is that patients often arrive in the ER hours after initial onset of symptoms, and delays in the ER setting may further delay the evaluation and the necessary CT exam. The result is that many stroke patients do not get the full benefit of the tPA treatment.

Researchers at Cornell University are working on a simple blood test, requiring no more than a drop of blood, which could lead to a quick diagnosis of stroke. The technology would detect several blood-borne biomarkers, molecules that appear in the blood when a stroke occurs. The research focuses on neuron-specific enolase (NSE), a substance found in higher concentrations in blood of stroke victims. The presence of NSE would send a signal to a device that would show a light, allowing early detection of the biomarker.

The researchers are working with a private company to develop this stroke-detecting approach for clinical testing. Eventually it would be made available for use in hospitals as a relatively small package. If it is effective, it would revolutionize the diagnosis and rapid treatment of stroke.