University of Cambridge
Scientific title
The effect of cerebrospinal fluid drainage and augmentation of cerebral perfusion on cerebral oxygenation and haemodynamics after subarachnoid haemorrhage
Principal Investigator
Mr Peter Kirkpatrick
Grant value
Research ID
TSA 2011/08
Research area
Start date
Saturday 1 December 2012
End date
Wednesday 18 March 2015
39 months

**Owing to lack of recruitment, this study was closed and the remaining funds returned to the Stroke Association**

This project will look at how blood and oxygen supply to the brain following spontaneous brain haemorrhage can be improved. Bleeding in the brain causes increased pressure in the skull resulting in a lack of blood and oxygen entering the brain. This can cause secondary brain injury which is the leading cause of disability in patients’.

Brain or cerebral blood and oxygen supply can be increased by releasing the fluid that accumulates in the head (cerebrospinal fluid) and reducing the pressure in the skull. Another method is to increase patients’ blood pressure and force blood into the head. Although these methods are widely used, their impact on brain blood and oxygen supply is unknown. Both procedures carry risks of complications including heart problems and severe infections.

The current “gold standard” of measuring blood and oxygen supply to the brain is using positron emission tomography (PET) scanning. However, this method is impractical for monitoring treatment effects over time due to radiation and costs involved. Another method, near-infrared spectroscopy (NIRS) uses light absorption, which can be applied non-invasively to all patients throughout their stay in the critical care unit but information gained by NIRS has not been fully validated.

We will perform PET scans and continuous NIRS monitoring in two groups of patients (15 each). In one group, excess fluid from the brain will be drained in a controlled manner, to release the pressure in the skull. In the second group blood pressure will be increased to try to force more blood into the brain. A scan will be performed before and after both interventions to see any improvement in brain oxygenation.