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Injecting Drug Directly into Brain Helps in Bleeding Stroke Recovery

Update Date: Feb 08, 2013 03:44 AM EST

Injecting a drug directly into the brain can liquefy a blood clot the size of a golf ball in people who have had a brain hemorrhage, a new study has found.

The new kind of surgery improves a patient's condition after a bleeding stroke and shortens hospital stay. It even helps preserve brain tissue that would have otherwise been lost due to the common bleeding stroke called intracerebral hemorrhages or ICH. This particular stroke, even if the patient survives, causes long-term disability. Currently there are no evidence-based treatments for this condition.

"There is now real hope we have a treatment for the last form of stroke that doesn't have a treatment - brain hemorrhage," said Daniel Hanley, M.D., lead author and professor of neurology at Johns Hopkins School of Medicine in Baltimore, Md. in a press release from The American Heart Association.

In ICH patients, a weak blood vessel in the brain bursts, spilling blood in the brain and disrupting the normal functioning of the brain. The spilled blood then forms clots.

In the surgery, the surgeons cut a small hole in the patients' skull. Next, they insert a catheter into the brain tissue affected by the stroke where the spilled blood has formed a clot. The clot busting drug recombinant tissue plasminogen activator (rtPA) is pumped into the clot. The drug is injected via the catheter every 8 hours for about three days. As soon as the clot breaks down, it is removed via the catheter.  

The surgery was effective in dissolving 57 percent of the clots on average in test subjects, while in the control group, just 5 percent of the clots dissolved naturally.

"The normal healing processes may be occurring more rapidly when you remove the blood. We believe we're actually stopping brain injury and preserving brain tissue that would otherwise be lost," Hanley said.

The study included 96 patients at 26 hospitals who had a bleeding stroke. Researchers found that people who had received the new surgery were more likely to recover faster and spend less time in hospital. Also, these people were less likely to be disabled. About 25 patients got the surgery, while 31 percent were provided post-stroke medical care.

The study was presented at the American Stroke Association's International Stroke Conference 2013.

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