MICA: Early thrombolytic intervention in acute stroke by imaging with Electrical Impedance Tomography

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Electrical Impedance Tomography (EIT) is a novel medical imaging method in which tomographic "slice" images are rapidly produced using rings of electrodes placed around the body. It is safe, portable and inexpensive. The principal applicant's group has demonstrated that EIT can rapidly image functional brain activity in neurological conditions like stroke, epilepsy and normal activity in animal models and has developed systems which work well in head-shaped tanks. Thrombolytic "clot-busting" treatment is a new treatment for acute stroke which must be given within three hours, but its take-up has been restricted because it is essential to undertake imaging of the head before it can be administered. This is because a sudden onset of weakness or disability which appears as a stroke, can be due to insufficient blood to a part of the brain or else bleeding into the brain. The clot-dissolving agent cannot be given until imaging has been used to assess if a bleed has occurred, as it could make the bleeding much worse with catastrophic consequences. EIT has the potential to provide an inexpensive portable unit for use in ambulances or GP surgeries which would revolutionise administration of this drug in acute stroke by providing imaging at the point of contact. This could be relayed over the internet to a radiologist who could then give permission for a paramedic to give the drug in the ambulance or in a remote centre. The plan is to make three technical improvements in imaging and design of a helmet or headnet containing the contacts needed for accurate brain EIT and test these objectively in tanks, anaesthetised rats and human patient studies. The final outcome will be a new EIT system design optimised for imaging in acute stroke, with rigorous evaluation of its performance in about 30 patients.