When Moses Pimentel found himself collapsed on his bathroom floor one Sunday morning last June, a stroke wasnB次元官网网址檛 the first ailment that came to mind. He even wondered why his wife called an ambulance.
Paramedics conducted a rapid assessment on the fit, healthy, 47-year-old Saanich parks staffer, and found telltale left body paralysis. They rushed him to the care of Dr. Andrew Penn, a neurologist at Victoria General Hospital.
Penn and his staff at VGH, the nucleus of stroke care for Vancouver Island, found PimentelB次元官网网址檚 underlying heart defect that triggered the stroke, but it was that rapid response that was crucial in preventing lasting damage. Pimentel regained control of his body the same day, was out of hospital in six days and back to work in two months.
B次元官网网址淲ithout that rapid assessment who knows what would have happened? I have a physical job and a family to take care of,B次元官网网址� Pimentel, who manages invasive species in Saanich parks, said at VGH on Thursday. B次元官网网址淚B次元官网网址檓 not sure what I would have done.B次元官网网址�
Recognizing that quick and early detection of strokes can save lives and medical resources, the Vancouver Island Health Authority and Genome B.C. have launched a $10 million project that will give emergency room doctors a tool for nearly instantaneous diagnosis of a minor stroke, called a transient ischemic attack (TIA).
B次元官网网址淚f you think of stroke as an earthquake, a TIA is the rumbling before the earthquake,B次元官网网址� Penn said during the project announcement at VGH.
About 10 per cent of minor strokes lead to full-blown major strokes within two days, but diagnosing a TIA is difficult and pricey. Less acute medical problems such as dizziness and severe headaches can look like a TIA, but it can take considerable medical resources to separate the mimics form the real thing.
B次元官网网址淭here are about 30 mimics of TIAs for different (medical) conditions,B次元官网网址� Penn said. B次元官网网址淭he full meal ticket is expensive. To investigate a TIA costs thousands of dollars involving dyes, radiation, CT scans or MRIs.B次元官网网址�
In 2004, VIHA allowed Penn to set up a stroke rapid assessment unit at VGH, which in turn allowed him to amass the largest stroke database in the world from 11,000 patients across Vancouver Island. About 4,000 blood samples from that database will allow the University of Victoria's Genome B.C. Proteomics Centre at the Vancouver Island Tech Park to crunch through reams of data, all to find the signal set of proteins associated with a TIA.
If researchers can nail down the pattern of proteins released by the brain during a TIA event, diagnosing a TIA could become a relatively simple blood test, rather than time-consuming brain scans. The project, the largest in VIHA's history, expects to see results within four years.
"VIHA took a gamble and set up a TIA unit to rapidly assess a TIA before a stroke hit. The project was a great success B次元官网网址� in two years weB次元官网网址檝e saved some 150 strokes on Vancouver Island," Penn noted. "But with that success came failure B次元官网网址� we were flooded with patients, but about half werenB次元官网网址檛 TIAs. They might be migraines or seizures or other things that might not need urgent care (in the ER). We needed a blood test to differentiate those who needed urgent care.B次元官网网址�
Dr. Brad Popovich, the chief scientific officer for Genome B.C., said it's hard to overstate the importance of Penn's database of Vancouver Island stroke patients. It holds more stroke information than any other major medical centre in the U.S. and Europe due to VIHA's centralized system, and was key to unlocking $10 million to get quick TIA detection off the ground.
B次元官网网址淭he funding for this project addresses critical and immediate needs," Popovich said. "Stroke is the No. 1 cause of adult disability and stroke patients are the leading users of long term care in Canada. This (TIA test) will be better, cheaper, faster B次元官网网址� this will bring tangible results to British Columbians and beyond."
VIHA estimates rapid TIA detection technology will help doctors prevent 4,000 strokes per year in Canada, cut risks for patients due to the use of radioactive dyes during the diagnosis, cut costs to the health system in terms of patient care, and allow for better use of MRI and CT scan machines.
At VGH, the stroke assessment unit is set to expand into the hospital's former emergency wing (the new emergency centre opened in 2009), which will give the stroke team six exam rooms and four offices, up from two rooms now.
B次元官网网址淗ealth professionals want to improve stroke care. A lot of people donB次元官网网址檛 understand the devastating affects on the lives, livelihood and families of stroke victims," said VIHA board chair Don Hubbard. "That is why this research is so important.B次元官网网址�
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