DECODING THE SECRETS BEHIND RECOVERY AFTER INTRACEREBRAL HEMORRHAGE
What is a Stroke?
A stroke occurs when a blood vessel that carries blood to the brain from the heart is either blocked or bursts. As a result, the part of the brain the blood vessel was supplying does not get the blood it needs and starts to die.
What is ICH?
An intracerebral hemorrhage (ICH) is a type of stroke where the blood vessel ruptures or bursts inside the brain (Figure 1). Even though these types of stroke are less than 20 percent of all strokes, ICH causes half of all stroke-related deaths. Patients who survive an ICH are often seriously disabled.
Some patients after ICH recover nearly back to normal again while others are left devastated by the stroke.
This may be true with the same size and location of hemorrhage. If we can identify the different proteins or biologic mechanisms that helps people to recover, we may be able to apply it to all ICH patients to improve recovery. This may relate to inflammation, new blood vessel growth or preserving the brain’s functions
The Recovery and Outcomes from StrokE (ROSE) study uses a special kind of MRI that looks at the connections within the brain.
The Recovery and Outcomes from StrokE – Longitudinal Assessment With Neuroimaging (ROSE-LAWN) study is the first long-term follow-up of patients with ICH that repeats the special MRI used at baseline (in the ROSE study)
as well as performing follow-up with a comprehensive examination in a time frame of years after the ICH. Our purpose is to identify what causes some patients to develop a progressive decline in their cognition or thinking.
"Intracerebral hemorrhage is the form of stroke that has the highest rates of disability and death. But some people seem to recover much better than others. This may relate to inflammation that occurs after this type of stroke. Some inflammation can cause damage while other types can improve repair of damage. We believe that if we can identify the molecular triggers that lead to improved repair, we can apply it to all patients to gain the benefits. In addition, there are some hemorrhages that cause stress and stretch of neurons that are now identifiable by special MRIs that can help target treatments. But we need the participation of patients with these types of hemorrhages to help future generations and improve outcomes."
The facts about intracerebral hemorrhage (ICH) are alarming:
Every year about 100,000 people in the US will have a hemorrhagic (bleeding) stroke. About 70% of those will be ICH strokes.
Half of ICH patients die within 30 days of their stroke and a large number of the survivors will have a major disability.
Family members of ICH patients are 3-5 times more likely to have an ICH than people without a family history of ICH.
There are no effective drugs treatments and surgery is only helpful in few situations.
~40% of patients with a brain hemorrhage will develop progressive cognitive impairment (problems with thinking) by 3 years after the ICH
We hope to develop new treatments to treat ICH after it’s occurred.
With these facts in mind, research centers and hospitals around the country have joined the Recovery and Outcomes of StrokE (ROSE) Project and ROSE-LAWN sub study. Our shared goal is to learn more about the genetic and environmental factors that affect ICH risk across racial and ethnic groups. In the end, we hope this work will give the medical community the information they need to develop a better understanding of ICH and to find new tests and treatments for it.
We need your help. The science to understand why this terrible type of stroke happened in your family can’t go forward without the participation of the people that are affected. Our research team has been particularly interested in the long-term complication of dementia occurring after an ICH with the finding that nearly 40% of patients will develop this complication within 3 years of having a brain hemorrhage. ICH triggers a very strong inflammatory response from the body to try and repair the hemorrhage but sometimes, that inflammation can cause damage and if it’s not regulated, can become a chronic problem. Not everyone has this occur and thus far, there are no known tests to determine who will have this complication. This research study builds on the contribution of many patients like yourselves who participated in the parent ROSE study for which you had blood markers drawn as well as a baseline research MRI. We hope that you’ll participate in a long term follow-up using the same procedures that you’ve already done in the ROSE study; a research MRI plus examination and surveys about your health. So, we are asking you to think carefully about taking part in the ROSE-LAWN sub study. Your choice to take part will help us figure out how to prevent and treat this type of stroke in future generations.
The ROSE/ROSE-LAWN Project Team
For more information or to enroll as a participant, contact us.