SpareBrain - Mechanisms and Prevention of Secondary Brain Injury in Subarachnoid Haemorrhage

Study Overview
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Brief Summary
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Subarachnoidal hemorrhage (SAH) is a cause of long-term disability and death. Annually about 1000 people in Finland suffer from SAH, their average age being under 50 years. SAH has a mortality rate of 12 % acutely and 40 % of patients die within a month from admission to hospital. In addition, 30 % of the surviving patients remain with neurological deficits. Most survivors of the primary insult suffer from secondary injury during the first 2-3 weeks from the insult. Despite the advances in neurosurgical and -radiological techniques and intensive care, the mortality and morbidity rates in SAH have not changed in recent years. There is still only limited understanding of the mechanisms of secondary insults causing brain injury after SAH. In this study the investigators are aiming to clarify the timescale and mechanisms contributing to the secondary insults. The investigators also explore usability of novel biomarkers to guide treatment of the patients suffering from SAH.

Detailed Description
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Subarachnoidal hemorrhage (SAH) is a cause of long-term disability and death. Annually about 1000 people in Finland suffer from SAH, their average age being under 50 years. SAH has a mortality rate of 12 % acutely and 40 % of patients die within a month from admission to hospital. In addition, 30 % of the surviving patients remain with neurological deficits. Most survivors of the primary insult suffer from secondary injury during the first 2-3 weeks from the insult. Despite the advances in neurosurgical and -radiological techniques and intensive care, the mortality and morbidity rates in SAH have not changed in recent years. There is still only limited understanding of the mechanisms of secondary insults causing brain injury after SAH. In this study the investigators are aiming to clarify the timescale and mechanisms contributing to the secondary insults. The investigators also explore usability of novel biomarkers to guide treatment of the patients suffering from SAH.

Official Title
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Observational Study on Mechanisms and Prevention of Secondary Brain Injury in Subarachnoid Haemorrhage

Conditions
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Aneurysmal Subarachnoid Hemorrhage

Intervention / Treatment
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* Procedure: Magnetic resonance imaging
* Procedure: Cerebral microdialysis catheter insertion


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: aneurysmal subarachnoid haemorrhage Exclusion Criteria: age under 18 years pregnant moribund patient

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| aSAH patients<br>Patients suffering from aneurysmal subarachnoid haemorrhage | Procedure: Magnetic resonance imaging<br> <br> Procedure: Cerebral microdialysis catheter insertion<br>* Is inserted only when invasive intracranial pressure monitoring is required. The same route with pressure probe is used for insertion.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neuroradiologically confirmed secondary injury lesions | Neuroradiological imaging (CT/MRI) is performed when clinically indicated and at 2 weeks after primary insult. | up to 2 weeks after the primary insult | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Neurological outcome of the patient | Neurological outcome is evaluated with modified Rankin Scale at 6 months. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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subrachnoid hemorrhage, secondary brain injury