Project summary
Preserving brain blood flow during stroke by preventing intracranial pressure elevation.
What is the issue for NSW?
Stroke caused by blockage of a brain artery is a leading cause of death and disability.
What does the research aim to do and how?
This project builds on the teams’ recent discoveries in the laboratory and patient imaging. Professor Spratt’s laboratory team discovered a rise in pressure within the skull (intracranial pressure – ICP) 24 hours after minor experimental stroke. We showed that such a pressure rise reduces blood flow further to those areas of brain most at risk of dying from reduced blood flow due to the stroke. This may worsen stroke outcome. The team showed that this occurs by a new mechanism, triggered by a molecule released into the fluid around the brain after stroke.
Additionally, the clinical team have used a new technique to measure pressure within the skull of patients, and shown that this normally remains very stable in people, but rises significantly 24 hours after minor stroke. This is quite a surprise, since previously it was assumed that pressure only increased because of brain swelling.
The teams’ results indicate that there is another, previously unrecognised, cause of pressure rise. Preventing this has the potential to save brain tissue and reduce disability after stroke. The team has discovered a way to do this, using body cooling (hypothermia). Again, disruptive thinking comes to the fore – hypothermia has previously been used in stroke and after cardiac arrest, but typically for 24-48 hours or longer, which may result in complications such as pneumonia. Studies show that a very short duration of cooling is all that is needed to prevent the rise in intracranial pressure, and reduce the stroke size.
Professor Spratt and his team are excited to be awarded this senior researcher grant, which builds on a program of work that started with new discoveries in the laboratory, has been confirmed in studies in patients, and is now nearing the stage of being ready for testing as a very promising treatment to improve the outcome of stroke patients.