Reducing the risk of secondary ischaemic stroke in patients with acute intracerebral haemorrhage: Multimodal definition of vulnerable phenotypes

Stroke is the second leading cause of death worldwide. Treatment for strokes caused by bleeding involves reducing blood pressure to stop the bleeding into the brain. However, this reduction in blood pressure may affect blood flow to the whole of the brain, inadvertently causing blockages and injury away from the site of the stroke.

I have shown there is a medication (sodium bicarbonate) that might help improve brain blood flow; however, before we try to use it, we must confirm that blockages after bleeding are actually caused by reduced blood flow within the brain. The presence of blockages after bleeding is unexplained and considered a significant challenge for brain bleeding care, specifically as blockages raise the risk of further strokes.

I will use ultrasound and more detailed brain scans to check if treatments we already give, for high blood pressure for example, or even changes in our breathing, make blood-vessel blockages worse. This research will show how and why inadequate brain blood flow occurs after bleeding and decide how we test our chosen medication to treat this.

I have extensive experience in assessing brain blood flow using brain ultrasound, altering brain blood flow using breathing techniques and importantly performing research studies in patients' who suffer brain bleeding. This Fellowship will provide advanced training from international experts in brain blood flow and techniques to assess the brain blood flow and imaging.

By assessing patients using both techniques, our ability to relate the lower brain blood flow to the damaging changes occurring in the brain tissue. Furthermore, these relationships will support development of innovative networks within the United Kingdom, unmatched worldwide, to enable capacity to deliver studies that bridge the gap between our understanding of disease mechanisms, its complications and overall outcome for the patient.