Breach in blood-brain barrier after stroke could mean more severe bleeding after treatment

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A new study from the National Institutes of Health’s National Institute of Neurological Disorders and Stroke shows that stroke patients who have more severe breaches of the blood-brain barrier might be at greater risk for severe bleeding in the brain after invasive stroke treatment.

The information was discovered through a new way of processing MRI of more than 100 patients who had suffered a stroke caused by a blood clot blocking blood flow to the brain and were then treated with a stent to remove or break up the blood clot within 12 hours.

Study author Richard Leigh, MD, analyzed the data to find that strokes that caused a greater disruption in the blood-brain barrier also left patients more vulnerable to bleeding after the stent treatment meant to break up the blood clots that caused the stroke in the first place. The areas of the brain with the most bleeding post-treatment were also where the breakdown in the blood-brain barrier had been shown to be most severe.

Armed with this new info, it’s possible physicians will decide certain patients’ benefits from stent treatments for strokes do not outweigh their risks, since bleeding into the brain can be dangerous. Those patients might do better with less invasive treatments such as drugs.

“It is too early to say how these images will be able to help guide clinical decisions, but they can expand how we think about stroke, especially as we try to broaden treatment options for this disease that can have devastating consequences,” Leigh said in a statement.