Cranial Temperature Early Diagnose Hemorrhagic and Ischemic Stroke
Cranial Temperature Early Diagnose Hemorrhagic and Ischemic Stroke
The cerebrovascular diseases can be approximately divided as two types, namely ischemic and
 hemorrhagic stroke. Intravenous thrombolysis within 3-4.5 hours is highly recommended for
 acute ischemic stroke patients. But it's difficult to diagnose the ischemic stroke with the
 hemorrhagic stroke from the early symptoms and signs. It's with high risk of enlarging the
 hematoma if the patients with hemorrhagic stroke received the thrombolytic drugs. And time
 cost by CT or MRI examination is likely to responsible for missing the narrow time window and
 poor prognosis of stroke patients. Consequently, seeking for a noninvasive, rapid, portable
 and inexpensive diagnosis method which can sensitively distinguish the stroke type before CT
 or MRI examination would be very helpful in treating the ischemic stroke patients.

 Because of the blockage in the cerebral supply artery, the heat from circulatory system will
 sharply decrease in infracted hemisphere among the ischemic stroke patients. The reduced
 brain temperature influenced the temperature on the ipsilateral forehead according to the
 data of our animal and preliminary clinical trial. In contrast, the temperature of the
 ipsilateral hemisphere showed a mild increase among the ischemic stroke patients in our
 preliminary experiment. The difference of the temperature tendency on the ipsilateral
 forehead has a great chance to be an early physical mark.

 In our study, 30 ischemic stroke patients and 30 hemorrhagic stroke patients will be
 recruited. In the process of recruitment, the patients with acute stroke attack in no more
 than 4.5 hours will be collected the temperature at the five point without head coverage,
 including ipsilateral tempora, ipsilateral forehead, galbella, contralateral forehead, and
 contralateral tempora. Then the stroke would be recruited into the ischemic and hemorrhagic
 group according to the later CT or MRI results in the hospital. The accuracy and sensibility
 of early brain temperature in distinguishing stroke type would be tested in comparison with
 the diagnosis of imaging examination.
Stroke is the leading cause of morbidity and disability among the aged population around the
 world, and its incidence is still rising recently. The cerebrovascular diseases can be
 approximately divided as two types, namely ischemic and hemorrhagic stroke. Their
 pathophysiological processes and therapeutical strategies are totally different. For
 hemorrhagic stroke, which takes up about 20% patients with cerebrovascular diseases, there is
 a lack of valid medical management in the very early stage except surgical hematoma removal.
 Whereas it's the key management for ischemic stroke to recanalize the occluded artery and
 restore blood flow before the irreversible brain damage. According the Guidelines for the
 Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack, intravenous
 thrombolysis within 3-4.5 hours is highly recommended for acute ischemic stroke patients. The
 time window of thrombolysis after ischemic stroke is extremely narrow and greatly affected
 the patients' outcomes.

 Despite the efficacious therapy exists, the rate of successful early thrombolysis is still
 awfully low, especially in the developing countries. Only 3-5% stroke patients can take
 advantage of the early thrombolysis. There are two major reasons response for such a low
 successful thrombolysis rate, including the civilian and some first-aid personnel hasn't
 mastered the timing of thrombolysis therapy for ischemic stroke. That would be improved by
 propaganda and education of the stroke knowledge. But what's more critical is the difficulty
 to diagnose the ischemic stroke with the hemorrhagic stroke from the early symptoms and
 signs. It's with high risk of enlarging the hematoma if the patients with hemorrhagic stroke
 received the thrombolytic drugs. For this reason, it's hard for the doctors to provide the
 correct treatment at the first time before imaging examination finished. And the time cost by
 CT or MRI examination is likely to responsible for missing the narrow time window and poor
 prognosis of stroke patients. Consequently, seeking for a noninvasive, rapid, portable and
 inexpensive diagnosis method which can sensitively distinguish the stroke type before CT or
 MRI examination would be very helpful in treating the ischemic stroke patients. The new
 method would enable the first-aid personnel to judge the stroke type in the ambulance and
 decide to apply intravenous thrombolysis or not.

 Because of the blockage in the cerebral supply artery, especially the cerebral middle artery
 which can't be compensated, the blood flow in the corresponding hemisphere would drop sharply
 among the ischemic stroke patients. Along with decreasing heat from circulatory system, the
 infracted hemisphere's temperature should drop. The reduced brain temperature influenced the
 temperature on the ipsilateral forehead according to the data of our animal and preliminary
 clinical trial. In contrast, the temperature of the ipsilateral hemisphere showed a mild
 increase among the ischemic stroke patients in our preliminary experiment. That's possibly
 because the early mitochondrial dysfunction and inflammatory reaction induced by the
 hematoma. The difference of the temperature tendency on the ipsilateral forehead has a great
 chance to be an early physical mark. Temperature test could be rapid and noninvasive, making
 this mark a promising method to help the doctors to distinguish the stroke type in very early
 stage. Earlier diagnosis of ischemic stroke means earlier thrombolysis and much better
 prognosis.

 In our study, 30 ischemic stroke patients and 30 hemorrhagic stroke patients will be
 recruited. In the process of recruitment, the patients with acute stroke attack in no more
 than 4.5 hours will be collected the temperature at the five point without head coverage,
 including ipsilateral tempora, ipsilateral forehead, galbella, contralateral forehead, and
 contralateral tempora. Then the stroke would be recruited into the ischemic and hemorrhagic
 group according to the later CT or MRI results in the hospital. The accuracy and sensibility
 of early brain temperature in distinguishing stroke type would be tested in comparison with
 the diagnosis of imaging examination. It should be emphasized that the diagnosis and
 following treatment should depend on the imaging examination and our brain temperature test
 is rapid and noninvasive. The therapy of the recruited stroke patients wouldn't be influenced
 by the trial and should be as usual as the standard therapy.
Inclusion Criteria:

 -  1.Patients aged 18 to 80 years. 2.Supratentorial hypertensive intracerebral hemorrhage
 diagnosed by head CT or MRI.

 3.The intracerebral hematoma is more than 10ml. 4.Ischemic stroke diagnosed by head CT
 or MRI. 5.Unilateral middle cerebral artery occlusion or infarcted volume more than
 1/2 of a hemicerebrum.

 6.The head temperature collection within 4.5 hours following stroke attack. 7.Glasgow
 Coma Scale between 5-10.

 Exclusion Criteria:

 -  1.the time after stroke attack exceed 4.5 hours. 2.The intracerebral hematoma is less
 than 10ml. 3.The infarcted volume less than 1/3 of a hemicerebrum. 4.With terminal
 cerebral hernia. 5.Pregnant women. 6.Serious impaired liver function, coagulation
 disorders, AIDS, combine other tumor or special condition.