2 steps to stop stroke: CT, blood test can predict recurrence

Stroke recurrence is a threat combatted with drug therapy and predictive testing. Researchers have combined CT imaging and genetic blood testing to identify individuals at risk for intracerebral hemorrhage (ICH).

The team, led by Mark A Rodrigues with the Centre for Clinical Brain Sciences at the University of Edinburgh in Scotland, published findings online Jan. 10 in Lancet Neurology.

“We aimed to develop a prediction model for the identification of cerebral amyloid angiopathy (CAA)-associated lobar intracerebral hemorrhage using CT features and genotype,” Rodrigues et al. wrote.

The researchers examined brain MRI of 110 adults who later died after presenting with ICH, a group with a median age of 83 and 55 percent women. The blood test collected APOE genotype data.

The prediction model, according to Rodrigues, aimed to identify risk of cerebral amyloid angiopathy (CAA), which is linked to stroke and dementia. For rule-out criteria, neither subarachnoid hemorrhage nor APOE possession had 100 percent sensitivity. For rule-in criteria, subarachnoid hemorrhage and either APOE possession or finger-like projections had 96 percent specificity.

“The CT and APOE genotype prediction model for CAA-associated lobar intracerebral hemorrhage shows excellent discrimination in this cohort, but requires external validation,” the researcher wrote. “The Edinburgh rule-in and rule-out diagnostic criteria might inform prognostic and therapeutic decisions that depend on identification of CAA-associated lobar intracerebral hemorrhage.”