Doctor: New tool acts 'as a witness' to gauge brain damage

New technology is allowing Seton Medical Center Austin staff to better diagnose stroke patients and advance national stroke research.

In late March, Seton doctors began using two advanced magnetic resonance imaging systems, or MRIs, when treating emergency room patients.

"One of the scanners is the highest level of MRI scanner commercially available, and the only one in Central Texas available in a hospital emergency room," said Dr. Steven Warach, Seton director of stroke medicine and chief scientific officer. "Seton [Medical Center Austin] is one of the few places in the world where doctors can get direct access to the highest level of scans to be used in emergency situations."

A stroke is when one or more blood clots stop the flow of blood to the brain. Less severe blood clots forming a shape similar to a solar eclipse partially block the blood flow to the brain, Warach said.

Typically ER doctors rely on computed tomography, or CT, scans, which are good for detecting brain damage and bleeding but ineffective at determining how long the brain has been bleeding, Warach said.

If doctors can detect a problem early enough, they can administer an anticlotting drug—a tissue plasminogen activator, or TPA—to help the patient.

If the CT scan shows nothing definitive, doctors cannot administer the TPA for safety reasons, he said.

Warach and the Seton/University of Texas Southwestern Clinical Research Institute are participating in a national study to determine if MRIs can pinpoint when a stroke took place.

The MRIs, Warach said, can perform more detailed brain scans and act "as a witness" to help doctors plan treatment.

"Right now, if a person goes to sleep [feeling] normally and wakes up having had a stroke, that stroke could have happened five minutes before he woke up or eight hours before," Warach said. "We have to assume it was eight hours before to be on the safe side."

Researchers will begin two other studies later this year. One will investigate whether patients' long-term health results are better and if costs are lower using MRIs, and another will look at if MRI data can help prevent stroke patients from having additional strokes, according to a news release.

"It is very exciting as a neurologist and stroke specialist to be able to see things in the brain and be certain of the diagnosis," he said. "Before these kinds of techniques, you had to make your best educated guess. Now we can see where the damage is and how advanced it is."