Grant: CIHR Fellowship

Hemorrhagic stroke, or bleeding into the brain, affects over 5 000 Canadians each year. It leaves 80% of victims dead or disabled. No early treatment is available at this time. Surgery to remove the blood clot does not work in most cases. It is known that these strokes are most often caused by high blood pressure. It is also known that bleeding continues for hours after the stroke begins. Larger blood clots are more often fatal and decrease the chances of recovery. High blood pressure is seen in most patients immediately after the stroke and this may contribute to further bleeding and death. At the same time, many doctors worry that lowering blood pressure too early will reduce the flow of blood to the brain, which could actually be harmful. The result is that doctors are not certain how to treat blood pressure in their patients with ICH. The objective of this study is to demonstrate any effects early blood pressure reduction may have on blood flow to the brain in hemorrhagic stroke patients. We believe that blood pressure reduction will not reduce blood flow to the brain and may improve outcome. We will test this theory by randomly assigning our patients to two different blood pressure targets; one high and one low. We will also use an x-ray technique known as CT perfusion to measure brain blood flow in our two groups of patients before and after blood pressure lowering. If there is no change in blood flow, we will have shown that early treatment of blood pressure is safe. This is a critical study if doctors are to learn how best to treat blood pressure in the early phases of this type of stroke.