STEMI for Stroke®
What is a Stroke?
A stroke is a sudden interruption in the blood supply of the brain. Most strokes are caused by an abrupt blockage of arteries leading to the brain (ischemic stroke). Other strokes are caused by bleeding into brain tissue when a blood vessel bursts (hemorrhagic stroke). Because stroke occurs rapidly and requires immediate treatment, stroke is also called a brain attack. When the symptoms of a stroke last only a short time (less than an hour), this is called a transient ischemic attack (TIA) or mini-stroke.
The effects of a stroke depend on which part of the brain is injured, and how severely it is injured. Strokes may cause sudden weakness, loss of sensation, or difficulty with speaking, seeing, or walking. Since different parts of the brain control different areas and functions, it is usually the area immediately surrounding the stroke that is affected. Sometimes people with stroke have a headache, but stroke can also be completely painless. (http://www.strokecenter.org/)
Ischemic Stroke from the MindRhythm Perspective
Ischemic strokes impact more than 800,000 people in the US per year. It is the 4th leading cause of deaths per year at more than 150,000. 15-30% of these stroke victims become permanently disabled. The MindRhythm technology is designed to differentiate between two forms of ischemic stroke. (https://cdc.gov/stroke/)
Large Vessel Occlusion (LVO)
A large vessel occlusion accounts for approximately 26% to 46% of ischemic strokes impacting approximately 80,000 US citizens per year. It is a blockage in one of the major arteries of the brain. These large vessels include the basilar artery, carotid terminus and middle cerebral artery, and occlusions therein cause loss of blood flow to significant portions of the brain. Higher-order brain functions tend to be disrupted, and these strokes tend to be more severe and result in less favorable outcomes for patients.1
Small Vessel Occlusion (SVO)
Small Vessel Occlusion or (SVO) account for approximately 25% of ischemic strokes. This stroke type occurs deep in the brain in vessels that do not primarily provide oxygenated blood to the brain and are considered less severe than LVOs. Small Vessel Occlusions often cause enduring and debilitating consequences including cognitive and motor impairment and mood disturbances, which could lead to functional decline and death.
1Smith WS, Lev MH, English JD, Camargo EC, Chou M, Johnston, CS, Gonzalez G, Schaefer PW, Dillon WP, Koroshetz WJ, Furie, KL, Significance of large vessel intracranial occlusion causing acute ischemic stroke. Stroke. 2009 Dec: 40(12):3834-3840. Doi: 10.1161/STROKEAHA.109.561787
Where Minutes Count We Save Hours
MindRhythm has developed technology that will improve outcomes in stroke by significantly expediting time-to-treatment: the most important factor in stroke outcomes. In situations where minutes count, we save hours.
The time saved can mean the difference between dying and walking out of the hospital without any deficits. Stroke is the most debilitating event a patient can suffer. Nothing on the market or on the horizon offers the potential to so dramatically improve outcomes as MindRhythm’s Harmony. Harmony is a novel, noninvasive diagnostic medical device that can rapidly identify patients with Large Vessel Occlusion (LVO) strokes, the most debilitating of all stroke types. These patients will benefit from rapid transport to a Comprehensive Stroke Centers (CSC) that have the physicians, technologists and equipment needed to remove the clot. In contrast, patients without LVO stroke will be transported to a Primary Stroke Center (PSC) which will likely be closer, also saving time to treatment.
Harmony monitors a newly discovered physiology MindRhythm calls the “headpulse”. The headpulse is measured by applying a highly sophisticated sensor to the patient’s head, measuring minute pulsations produced by each heartbeat. The headpulse changes dramatically during LVO strokes, as does the signal read by Harmony. Coupling the Harmony results with a simple clinical examination of limb weakness, we can discriminate LVO strokes among Code Stroke patients. Nearly 20% of Code Stroke patients are stroke mimics, including migraine and post-seizure and Harmony can reliably tell an LVO stroke from a stroke mimic. Additionally, because endovascular surgical teams commonly express frustration at not knowing when patient transport is going to arrive, Harmony transmits GPS location data to the receiving hospital so that the surgeons can track the patient in real-time.
STEMI for Stroke
Analogous to STEMI for heart attack, urgent evaluation of a patient with a suspected stroke is called a “Code Stroke” to underscore the time urgency for treatment. Currently there is no objective measure Emergency Medical Service (EMS) personnel can use to correctly identify an LVO stroke when responding to a Code Stroke.
Compounding this issue, different types of hospitals have varying levels of ability to treat different types of strokes. The inability to accurately triage a patient and transport them to the correct hospital has profound consequences. A patient who is sent to the wrong hospital after CT confirmation of an LVO stroke needs to be transferred to a CSC for treatment wasting precious time. During this delay, the brain is dying due to reduced blood flow, losing 2.6 years of life for every hour of delayed treatment. This is a widely known deficiency in medicine for which the stroke treatment community has been actively seeking a solution
Harmony, combined with a simple clinical examination of limb weakness, eliminates the LVO stroke triage conundrum and ensures patients are transported to the appropriate hospital, resulting in enormous benefits to patients, their families and society. Harmony is a headband placed by EMS personnel that utilizes sensors to noninvasively detect changes in brain vibrations. The Harmony algorithm requires only a minute or two of data to determine if the patient is suffering an LVO stroke.