Time is Brain: How High-Tech Goggles Could Transform Stroke Diagnostics

When it comes to strokes, the saying is true: time is brain. The quicker you are able to identify your symptoms as a stroke and begin treatment, the better your chances of recovery. And while sometimes the symptoms are very clear, such as trouble with speech or face drooping, others are less obvious. For example, dizziness, vertigo and nausea can all be signs of a stroke – but they’re also the most common symptoms of an inner-ear infection.

So how can ER doctors quickly tell the difference? According to a recent study, nearly half of the 4 million people who visit U.S. emergency rooms each year with dizziness are given an MRI or CT scan. But there’s a problem with that method. Not only is it incredibly pricey, but it’s also not very accurate immediately after a stroke. The study found that within the first 24 hours of symptoms, CT scans missed 85% of strokes that restricted blood flow to the back portions of the brain, and MRIs missed nearly 20%. And when time is brain, this is not good.

Georgios Mantokoudis, left, and Ali Tehrani demonstrate the use of a video-oculography machine that detects minute eye movements that are difficult for most physicians to notice and can help diagnose stroke. (Credit: Johns Hopkins Medicine)

Georgios Mantokoudis, left, and Ali Tehrani demonstrate the use of a video-oculography machine that detects minute eye movements that are difficult for most physicians to notice and can help diagnose stroke. (Credit: Johns Hopkins Medicine)

But a new pair of high-tech goggles hope to offer a solution. The ICS Impulse goggles monitor eye movement in the dizzy patient, and can determine based on these movements whether the dizziness is related to something vestibular, like an inner-ear infection, or a stroke. The goggles have a motion sensor for the head and a camera that records eye movements. They then plug into a laptop that analyzes how the eyes and head move in relation to one another.

So how does that help ER doctors diagnose a stroke? If the eyes are not responding to head motion with the usual reflex, then that’s a signal the vestibular nerve that connects the inner ear to the brain could be inflamed or even infected, thus causing the dizziness. But if the eye reflexes remain intact, that signals to the doctor it is not a vestibular issue and the root of the dizziness could be a stroke.

So how accurate is it? In a small study of  dizzy ER patients, the goggles were shown to be 100% accurate. Pretty cool, huh? The study’s lead author David Newman-Toker, an associate professor of neurology and otolaryngology at the Johns Hopkins University School of Medicine, predicts 50,000 to 70,000 patients a year whose strokes are misdiagnosed could be properly and quickly diagnosed with this technology. And if it becomes widespread, it will be a money saver, too. An MRI test can cost more than $1,200 – and Newman-Toker estimates the goggle exams will cost about $100.

But it’s not there yet. While the goggles have been approved by the FDA for assessing balance, they are not yet approved for dizzy ER patients. As the research continues, we’ll be interested to see if this becomes a widespread diagnostic tool and how it will benefit people who have had strokes in their long-term recovery.

To learn more about this technology, check out this piece in the Washington Post.

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