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In the January issue of Clinical Chemistry , Foerch and colleagues (1) report on the diagnostic accuracy of plasma glial fibrillary acidic protein (GFAP)2 for differentiating intracerebral hemorrhage (ICH) and cerebral ischemia in patients with symptoms of acute stroke. This major, welcome effort from the Biomarker for Rapid Diagnosis of Hemispheric Stroke (BE FAST!) group cites highly significant differences in plasma GFAP collected within 4.5 h of symptom onset for acute stroke. No fewer than 14 centers (13 German and 1 Swiss) collected data on 205 patients during the 1-year period between June 1, 2009, and May 31, 2010. The diagnostic accuracy for ICH generated P values of <0.001, compared with ischemic stroke (IschSt) or stroke “mimic.”A readily performed blood test that showed this large a difference would affect the management of acute stroke. It could spare the lost time and efforts of acute imaging tests to rule out ICH and …

A Strong Start: Plasma Glial Fibrillary Acidic Protein and Stroke Differential Diagnosis