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Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Senior Researcher Anna Rosell Novel, Hospital Vall d'Hebron, Spain
- Second opponent: Associate Professor Steffen Tiedt, Ludwig Maximilian University of Munich, Germany
- Third member and chair of the evaluation committee: Associate professor Jean-Luc Boulland, University of Oslo
Chair of the Defence
Associate Professor Kay Oliver Schink, University of Oslo
Principal Supervisor
Vice-rector Kristi Grønvold Bache, Kristiania University College, Norway
Summary
Rapid initiation of diagnosis-specific treatment is crucial to improve patient outcome in acute stroke. Current clinical practice depends on brain imaging to differentiate hemorrhagic and ischemic stroke, but the availability of CT-scanners is limited. This thesis has tested the diagnostic potential of circulating biomarkers to differentiate hemorrhagic and ischemic stroke in the hyperacute phase.
Blood samples collected in the prehospital environment and at hospital had Glial Fibrillary Acidic Protein (GFAP), Ubiquitin C-terminal Hydrolase-L1 (UCH-L1), Factor VII Activating Protease (FSAP) and nucleosomes measured. We have confirmed the diagnostic potential of GFAP and have shown that a group of patients with intracranial hemorrhages can be identified by this biomarker. By combining stroke symptoms and GFAP, patients suffering from large vessel occlusions can be detected more specifically. UCH-L1, FSAP and nucleosomes had limited diagnostic potential. Despite the limited diagnostic potential, our results support a role for FSAP in the pathophysiological mechanisms initiated after both hemorrhagic and ischemic stroke. The exact mechanisms involved require further investigation.
One or two biomarkers do not hold the diagnostic potential to differentiate hemorrhagic and ischemic stroke with the accuracy needed for the initiation of treatment for ischemic stroke patients. Further research is needed to identify a panel or fingerprint of biomarkers to make this treatment decision possible.
Additional information
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