Marcus Funds Research to Revolutionize Stroke Care

In what is hoped will be a major step forward in the treatment of strokes, the Marcus Foundation is underwriting research on a new surgical technique that promises to radically improve survival for stroke patients. The new research project will be funded by a $25.9 million grant. It’s believed to be the largest grant ever made to improve the surgical outcomes of the life-threatening condition.

In the deadliest of these strokes, which occur deep within the brain, up to half of patients die within the first year, many within the first few days. Eighty percent of those who survive can expect substantial disability.

But new research, reported in the New England Journal of Medicine earlier this year, promises the possibility that many of those who now die can be saved and returned to productive lives with little or no residual effects of their brush with death.

Today, it’s estimated that care for these survivors costs the nation’s health care system $17 billion each year with another $12 billion in lost productivity and additional care. It’s something Bernie Marcus, co-founder of The Home Depot and head of the Marcus Foundation, is determined to change.

“After witnessing the staggering cost, I knew we had to do more to discover new treatment options,” Marcus said. “Breakthroughs like this new approach for the deadliest form of stroke and others made by the stellar team at the Marcus Stroke and Neuroscience Center will save and change lives around the world for decades.”

The study in the New England medical journal described a revolutionary way of entering the brain through an opening in the skull about the size of a quarter. A small surgical brain path device then makes its way through brain fibers by pushing them aside. A second tool called a myriad device mechanically is positioned in the brain to break up the blood clot that has occurred to cause the stroke and suction it up.

For Dr. Gustavo Pradilla, lead researcher for the study and chief of neurosurgery at Grady Health System and a professor of neurosurgery at Emory School of Medicine, the new procedure has already produced dramatic results in incidents of stroke near the brain surface.

“First, it removes the pressure immediately on the brain. Second, it allows us to find the source of the bleeding and closes it off completely so there’s no risk of re-bleeding or expansion. That means patients are out of intensive care faster and have a shorter stay in the hospital. And once they were home, there quality of life improved significantly.”

With the new Marcus grant, Dr. Pradilla hopes to achieve the same impressive results in hemorrhages deeper in the brain.

The multi-million-dollar award will test whether victims of what is called intra-cerebral hemorrhage (ICH) can be treated for bleeding from ruptured blood vessels directly within brain tissue.

It’s estimated that this year at least five million people will suffer from strokes caused by brain hemorrhages often with catastrophic results. The five-year study of 600 patients, which the Marcus funding will pay for, is being done at 60 hospitals around the country, including at the Marcus Stroke Center at Grady Memorial Hospital. Dr. Pradilla is not only looking at saving lives, but of returning patients to productive lives, even when the stroke occurs deep in the brain — something once thought impossible.

“We’re looking at the safety of the procedure,” Dr Pradilla remarked, “and No. 1, to be able to remove as much blood as possible, but No. 2 is to improve brain function. We want, at six months after you’ve had the procedure, to have a substantial improvement in brain function.”

Medical researchers emphasize that the progress that has been made in the surgical treatment of strokes would not have been possible with the recent advances in the mapping of brain function. The Human Connectome Project has been able to construct a picture of how the brain works and how various parts of the brain function and interact with one another.

Prior to the mapping of the brain, neurosurgeons risked permanent damage to their patients when their instruments disrupted brain functioning. Furthermore, the same advances in imaging technology that helped make possible the detailed description of how the brain works made it possible to surgically move through the brain more efficiently.

For Dr. Pradilla, whose grandfather died from a stroke, the new techniques and the possibility of future success has been deeply satisfying.

“It brings a tremendous amount of hope for something that, in the past, was essentially a sentence of death or disability.”