Experimental stroke treatment shows promise

A radical experimental approach to treat stroke patients at the University of Alberta Hospital, by administering a cocktail of drugs and inducing mild hypothermia, is showing promising results.

The treatment combines four drugs and mild hypothermia. Previously, only two-drug research tests have been used, said Dr. Ashfaq Shuaib, director of the division of neurology in the Faculty of Medicine and Dentistry at the University of Alberta, and section head of neurology with Capital Health.

Stroke patient Randy Greene can testify to the treatment's value. Green, 57, suffered a stroke last Oct. 2 at his home in Tofield, nearly an hour's drive southeast of Edmonton. Paramedics administered one of four drugs being used in Shuaib's MINUTES (Multiple Interventions for Neuroprotection Utilizing Thermal Regulation in the Emergent Treatment of Stroke) research project. Once Greene arrived at the hospital, he was given three other drugs. The treatment also incorporates a head-cooling device to protect the brain by inducing clinical hypothermia.

"Cooling affects the cascade of biochemical processes that start with a lack of oxygen to the brain," explained Dr. Muzaffar Siddiqui, a U of A neurology professor and a Capital Health Stroke Fellow. "In treating strokes, time is brain, so the sooner we can start treatments, the better."

None of the drugs are used in the treatment of strokes, so are considered experimental in this case, said Shuaib.

Shuaib said the approach puts stroke treatment where AIDS treatment was in the mid-1990s, before so-called drug cocktails were used in a multi-pronged approach to treating ischemic stroke, the most common type.

Between 55,000 and 60,000 Canadians will suffer a stroke this year, and treatment costs - as a result of physical disability following a stroke - add up to about $4 billion annually, Shuaib said.

"Our goal is to decrease the severity of a stroke out of hospital and cut down on disability," he said, adding that so far, six patients have undergone the treatment. The research project needs to test it out on a total of 37 patients.

"The preliminary results are encouraging," he said.

Greene certainly thinks so. "I was in my garage reaching up for a tool and I just went down," said Greene, who had to crawl back into his house, because his right leg and arm were paralyzed. "I didn't know what was going on . . . the next day I was wiggling my toes."

"We were delighted to see him dance out of here," said Siddiqui.