Invited article: searching for oracles? Blood biomarkers in acute stroke

Neurology. 2009 Aug 4;73(5):393-9. doi: 10.1212/WNL.0b013e3181b05ef9.


Emerging data suggest that a wide array of measurable biomarkers in blood may provide a novel window into the pathophysiology of stroke. In this review, we survey the state of progress in the field. Three specific questions are assessed. Can biomarkers augment the clinical examination and powerful brain imaging tools to enhance the accuracy of the diagnostic process? Can biomarkers be used to help triage patients for thrombolytic therapy? Can biomarkers help predict patients who are most susceptible to malignant infarction? Many encouraging molecular candidates have been found that appear to match the known cascades of neurovascular injury after stroke. However, whether these putative biomarkers may indeed have direct clinical utility remains to be quantitatively validated. Larger clinical trials are warranted to establish the sensitivity and specificity of biomarkers for routine use in clinical stroke.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Biomarkers / analysis*
  • Biomarkers / blood*
  • Blood Proteins / analysis
  • Blood Proteins / metabolism
  • Brain / blood supply
  • Brain / metabolism*
  • Brain / physiopathology
  • Brain Ischemia / blood
  • Brain Ischemia / diagnosis
  • Brain Ischemia / drug therapy
  • Cerebral Hemorrhage / chemically induced
  • Cerebral Hemorrhage / physiopathology
  • Cerebral Hemorrhage / prevention & control
  • Humans
  • Patient Selection
  • Predictive Value of Tests
  • Stroke / blood*
  • Stroke / diagnosis*
  • Stroke / physiopathology
  • Thrombolytic Therapy / adverse effects
  • Thrombolytic Therapy / standards


  • Biomarkers
  • Blood Proteins