Effect of Ischemic Strokes on Recovery From Intracerebral Hemorrhages

Intracerebral hemorrhage (ICH) is a type of stroke that leads to bleeding in the brain. It accounts for about 10-15% of all strokes in the United States. ICH has the highest risk of death among stroke types. Despite advances in medicine, the number of patients that survive after an ICH has not changed in the past 20 years. Furthermore, current treatments to limit bleeding in the brain have not led to improvement in patient recovery. Thus, no proven therapy exists for patients with ICH.

Over the course of one's life, risk factors such elevated blood pressure and cholesterol can weaken the small arteries of the brain leading them to rupture and cause an intracerebral hemorrhage (ICH). These same risk factors can also cause these arteries to narrow and occlude leading to another type of stroke called an ischemic stroke. Recent data suggest that certain patients with ICH can also develop ischemic strokes. In this study, we will use magnetic resonance imaging (MRI) to examine the occurrence of ischemic strokes in ICH patients. The purpose is to see whether the presence of ischemic strokes affects an ICH patient's ability to recover neurologically. Our hypothesis is that the presence of ischemic strokes can worsen the outcome of patients with ICH. Furthermore, we hope to use our data to raise new questions as to why ischemic strokes occur only in some patients with ICH.

If ischemic strokes are found to worsen the chance for neurologic recovery, they may provide a new treatment target in patients with ICH. Using our data, we plan to define potential causes for these ischemic strokes. We hope this will lead to a new study testing treatments that may prevent ischemic strokes and improve recovery in ICH patients. This would be a major shift in the care of patients with ICH. Besides limiting bleeding in the brain, prevention of other types of brain injury such as ischemic strokes may be important in improving outcomes.