Diagnosis and Prognosis of Stroke: A Novel Approach

Neurofilament Light a determinant for stroke related brain injury

It is now possible to determine the extent of brain injury from different types of strokes and predict prognosis in these patients by using a blood biomarker.

Neurofilament light (NFL) is the new blood biomarker a protein abundant in brain neurons. Following injury of neurons due to stroke or other neurological disease, this biomarker is released into the cerebrospinal fluid (csf) that bathes the brain and then into the blood. The volume of NFL present in the blood is an indicator of neuron injury in the brain. Although stroke is the main cause of death however, the symptoms vary widely from temporary and nondisabling to severe long-term impairment.

Ability to estimate the severity of a stroke and how well a person is expected to recover is an important criteria in stroke diagnosis as it provides relief information to the victim’s relatives. Reliable prediction of a patient’s prognosis is an important requirement in care, in this way the cause of treatment and measures for rehabilitation are easily determined.

From Ischemic stroke involving blockage of blood flow to the brain to hemorrhagic stroke which is due to bleeding in the brain as a result of blood vessel burst a reliable quantification of the amount of NFL present in the blood is a good determinant in stroke prognosis.

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A retrospective study on a population of 314 patients who had suffered a stroke and 79 healthy patients, who donated blood, NFL concentrations were determined to show if they were elevated by stroke and whether it was an indicator of stroke severity and eventual recovery. This was achieved by correlating NFL levels and the degree of brain injury, neurological, functional, or cognitive status of patients. Future recovery outcomes by reliably predicting post-stroke outcomes and survival was also determined using NFL levels.

The findings were that, NFL blood levels are good determinants of stroke severity. Thus high levels of NFL were indicators of worse outcomes leading up to mortality. This was elicited in ischemic stroke and hemorrhagic stroke. This is evidence of NFL as a good prognosticator of stroke.

Using NFL blood test as compared against brain imaging might be a more feasible approach in the diagnosis of stroke and its prognosis. The advantages of these findings are on the method of approach for treating patients, and would go a long way to determine treatment and future needs of stroke patients.

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