Two simple tests could help to pinpoint cause of stroke

Two simple tests could help to pinpoint cause of stroke


Thursday, 11 January, 2018

Dr Mark Rodrigues, Professor Rustam Al-Shahi Salman (both Centre for Clinical Brain Sciences) and colleagues have published findings indicating that detecting the cause of the deadliest form of stroke could be improved by a simple blood test added alongside a routine brain scan. Their findings suggest that a genetic test for APOE, combined with a CT scan, could be used to detect stroke caused by intracerebral haemorrhage (ICH).

Intracerebral Haemorrhage (ICH) accounts for up to 50 per cent of all strokes worldwide and around half of those affected die within one year.  ICH can be caused by a condition called cerebral amyloid angiopathy (CAA) which is caused by a build-up of a protein known as amyloid in the walls of blood vessels in the brain. It is linked to a higher risk of further strokes and dementia. 

The researchers used computed tomography (CT) scans in more than 100 patients, who died following their first ICH. They collected blood samples to test the APOE gene, which is linked to CAA. By combining simple CT scan images with a genetic blood test, researchers could accurately spot if an ICH had been caused by CAA. Combining the test with a brain scan could provide key genetic information that may help identify those most at risk from a second stroke.

Dr Mark Rodrigues, Wellcome Trust Clinical PhD Programme Fellow, Centre for Clinical Brain Sciences said:

"This new approach could help identify people who are at higher risk after their ICH, revolutionising the way doctors manage this type of stroke.  It could also improve ICH diagnosis in developing countries, as CT scanning and blood testing are available worldwide.  Identifying the cause of a brain haemorrhage is important to planning patient care. Our findings suggest that the combination of routine CT scanning with APOE gene testing can identify those whose ICH has been caused by CAA – a group who may be more at risk of another ICH or dementia."