RecruitingNCT06410274

Ischaemic Lesions in Acute Intracerebral Haemorrhage

Ischaemic Lesions in Acute Intracerebral Haemorrhage: Pathophysiological Investigation Using Novel Multimodal Cerebral and Systemic Haemodynamic Assessments

Sponsor

University of Leicester

Enrollment

120 participants

Start Date

Jun 1, 2024

Study Type

OBSERVATIONAL

Conditions

Intracerebral haemorrhage

Summary

The aim of this observational study is to determine how and why inadequate brain blood flow occurs after bleeding in patients with intracerebral haemorrhage (ICH). Treatment for strokes caused by burst blood vessels involves reducing blood pressure (BP) to stop the bleeding. However, this reduction in BP may affect blood flow, causing blockages in blood vessels within the brain. Fast breathing also affects brain blood flow. Therefore, participants will be asked to undergo a simple brain blood flow assessment using transcranial Doppler (TCD) within 48 hours upon admission to hospital. Patients will then have a follow-up TCD assessment at 4-7 days post-ICH onset, in addition to an MRI scan at \>7 days. This research will help to confirm if blockages after bleeding are caused by reduced blood flow within the brain.

Eligibility

Min Age: 18 YearsMax Age: 120 Years

Inclusion Criteria2

Clinical diagnosis of a haemorrhagic stroke on CT imaging within 48 hours of onset (for patients waking with a stroke, time of onset will be taken to be the time when the patient was last asymptomatic).
Male or female, aged 18 years or above.

Exclusion Criteria4

MRI imaging is contraindicated or unlikely to tolerate scanning process due to clinical instability (GCS <8, unable to lie supine).
Patients requiring anaesthesia.
Male or Female, aged under 18 years.
Clinical diagnosis of stroke greater than 48 hours from onset

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Interventions

DEVICETranscranial Doppler ultrasonography (TCD)

TCD will be used to measure cerebral blood velocity (CBv) in the middle and posterior cerebral arteries (MCA and PCA). Following confirmation of a suitable TCD window, participants will undergo a ten-minute rest period in the supine or semi-supine position. Continuous measurements of CBv, blood pressure (BP), heart rate, and end-tidal carbon dioxide will be recorded. Baseline BP will be measured using an automated BP device prior to each recording to allow calibration of the files offline for analysis. This will occur at the first visit and at follow-up, 4-7 days post-onset of intracerebral haemorrhage.