Can Biomarkers Differentiate Between Ischemic and Hemorrhagic Stroke in the Prehospital Setting

Distinguishing ischemic from hemorrhagic stroke has important implications for acute treatment. Thrombolytic therapy is of benefit for patients with ischemic infarctions but is contraindicated in intracranial hemorrhage.1 Brain imaging is the workhorse to differentiate ischemic from hemorrhagic stroke because clinical symptoms are nonspecific. A plasma-based biomarker to aid in the distinction of these 2 stroke subtypes has long been sought, but to date, sufficient sensitivity or specificity for clinical use has not been achieved.2