Resetting the stroke clock

New brain-imaging software identifies people who might benefit from treatment long after the time it has generally been considered helpful.

Illustration of brain and blood clot. Riki Blanco artwork

When Cindi Dodd’s husband awoke her at 5 a.m. one day last year, something was wrong. “I knew what I was trying to say in my mind, but it had nothing to do with the sounds that were coming out of my mouth,” Dodd, 47, says.

She had suffered a massive ischemic stroke. Now, she credits brain-imaging software developed by Stanford researchers with saving her life and preventing permanent disabilities.

At the time, treatment to remove clots was considered helpful for only six hours after a stroke. It wouldn’t have been an option for Dodd, since the time of her stroke was unknown. But the software, which assesses salvageable brain tissue, indicated that a thrombectomy, a clot-removal procedure, could help her.

“I am literally standing on this Earth as a wife and a mother because of that procedure,” says Dodd.

A 182-patient trial of the software, funded by the National Institutes of Health and led by Stanford researchers, showed that the procedure was beneficial for up to 16 hours after a stroke.

“Nearly half of all patients treated between six and 16 hours after the onset of their symptoms were largely spared from the consequences of their stroke,” says the trial’s principal investigator Gregory Albers, MD, professor of neurology and neurological science and director of the Stanford Stroke Center.

The trial results, published Jan. 24 in The New England Journal of Medicine, were key to a decision by the American Heart Association and American Stroke Association to extend the treatment window to 24 hours.