Grant: Travel Awards - Institute Community Support

Hemorrhagic stroke, also known as "bleeding stroke", is caused by the rupture of blood vessels within the brain. It is the second most common form of stroke and is arguably the most devastating. When they first present to hospital, patients with hemorrhagic stroke are often still bleeding into the brain, and the bleed can expand and enlarge. This phenomenon, termed hematoma expansion, is responsible for the poor outcomes seen in patients with hemorrhagic stroke. In most cases, blood expands and pushes onto adjacent brain tissue. But in at least a quarter of patients, blood can also expand into the ventricles of the brain. The presence of blood in the ventricles is particularly devastating and often impairs recovery. However, we know very little about the full effects that new or expanding ventricular blood can have on survival and recovery after hemorrhagic stroke. In this study, we sought to better understand the relationship between new or expanding ventricular blood and long-term recovery. Through an international hemorrhagic stroke collaboration, we used the data of hundreds of patients with hemorrhagic stroke to build a predictive model looking at expanding ventricular blood and outcome at 90 days post-stroke occurrence. We found that even small amounts of ventricular blood expansion, less than a teaspoon, was strongly predictive of disability and death. Individuals who had blood develop in their ventricles were at three times increased odds of dying by 90 days. We validated our findings in a separate hemorrhage database, courtesy of our colleagues at Harvard University, and found similar findings. Our study shows the importance that ventricular blood has on the outcomes of patients with hemorrhagic stroke. Our findings suggest that stopping ventricular blood expansion could be a novel target for future therapies. Our findings can also help researchers refine their clinical trials to help discover future treatments for this disease.