Early Stroke Diagnosis

Cerebrovascular accident (CVA) or stroke is one of the major causes of impairment and morbidity in this country. Stroke is the third leading cause of death in the U.S. and costs billions of dollars in care and disability. Both the American Heart Association (AHA) and the American Stroke Association (a division of AHA) classify CVA as an emergency ranking up there with a heart attack that should be responded to with the same degree of urgency; from calling 911 to receiving prompt medical attention and immediate intervention in the emergency department.

A stroke is usually diagnosed by observations of behavior, slurred speech, partial paralysis, a neurological assessment, and tests like a CT, doppler ultrasound and an MRI. . These are not definitive since many diseases share or mimic symptoms of other conditions. With over 3 million people presenting to the ED with stroke-like symptoms each year and almost 700,000 being positively diagnosed with a stroke, early diagnosis is important for both financial and clinical reasons.

Generally, the lab has not been in the forefront of the diagnosis of CVA. However, recently, there has been renewed interest in pursuing certain in vitro tests some think might serve as early markers of stroke. The current thinking is if those who have suffered a stroke can be positively identified and aggressive intervention pursued within 3 hours, the outcomes can be vastly improved.

Clinical laboratory researchers are optimistic about a group of markers such as Lp-PLA2, NMDA-receptor autoantibodies, and NR2A that they believe could play a significant role not just in the diagnosis of stroke, but also in early risk assessment. Once again, the clinical laboratory appears to have the potential for playing a significant role in early diagnosis of a serious illness.