Improving the chances of recovery from brain haemorrhage

Words by Sally Mavin

Image by iStock/DrAfter123

Every five minutes, someone in the UK will have a stroke, with one in ten of these a brain haemorrhage. Manchester researchers are preparing to launch a care package across north-west England that could save more lives from these severe strokes.

Fiona Moss will never forget the callย that changed her life forever. It wasย 2011, and she was in her secondย year of university, getting ready to celebrateย a friendโ€™s birthday. Then the phone rang. Herย sister Natalie had been rushed to hospital.ย Sheโ€™d had a brain haemorrhage.ย 

Natalie was just 26 years old, a Manchesterย graduate whom her sister described as kind,ย generous and a friend to everyone.

โ€œNatalieโ€™s brain haemorrhage struck out ofย nowhereโ€, Fiona says. โ€œShe was at an event inย London when she developed a severe headacheย and began vomiting. She was rushed to hospitalย for treatment, but ended up in a coma. Weย played a painful waiting game. But after fiveย days in intensive care, she passed away.โ€

Brain haemorrhages โ€“ or haemorrhagicย strokes โ€“ are caused by bleeding in and aroundย the brain. They are generally more severe thanย strokes caused by a blockage. Around one thirdย of patients donโ€™t survive longer than aย month, and many who do survive are left withย lifelong disabilities.

Survival rates have remained stubbornlyย constant for 30 years, but clinical researchersย at Manchester are set to introduce a careย package for patients across the north-west thatย could reduce deaths by a third.

"OUR HOPE IS THAT MANCHESTERโ€™S RESEARCH WILL HELP MORE PEOPLE SURVIVE BRAIN HAEMORRHAGES."

Transforming care

Dr Adrian Parry-Jones is a consultantย neurologist based at the University and atย Salford Royal NHS Foundation Trust. As aย clinical scientist, he works with academicย researchers, clinical colleagues and patients toย improve care.ย 

Dr Parry-Jones and his team have recognisedย a number of issues in the treatment ofย haemorrhagic stroke. โ€œWhen someone hasย had a brain haemorrhage, itโ€™s important to actย quickly. But itโ€™s often the case that the minuteย a doctor sees blood on the brain scan theyย immediately refer them to neurosurgery,โ€ heย explains. โ€œHowever, surgery might not be theย best option, and this referral process delaysย other treatments that could be more effective.โ€

In 2015, Dr Parry-Jones and his teamย introduced a care package called the ABCย Bundle for brain haemorrhage patients,ย including an innovative app to supportย clinicians. The A stands for anticoagulantย reversal, the B for blood pressure loweringย and the C for care pathway. These threeย stages respectively reduce the risk of furtherย bleeding, guide clinicians on treatments toย control blood pressure, and provide criteriaย for referring patients to neurosurgery.

The ABC Bundle has proven to be a hugeย success, reducing deaths at Salford Royal by aย third, which equates to saving two lives everyย month. In 2017, the project was scaled upย into two further stroke units in Stockport andย Bury. And now Dr Parry-Jones and his teamย are preparing to roll out the bundle across theย north-west.ย 

An incredible legacy

For Fiona and her family, they are turning aย personal tragedy into an incredible legacy,ย setting up a trust that supports crucialย research into stroke at Manchester. Recently,ย they have been joined by hundreds of alumniย who have helped fund a new PhD post inย stroke research at the University.

โ€œMy family have learned the hard way thatย stroke can affect anyone, at any stage of theirย life,โ€ says Fiona. โ€œIn the nine years since Natalieย died, weโ€™ve already seen encouraging progress.

โ€œOur hope is that Manchesterโ€™s researchย will help more people survive brainย haemorrhages. Or, better still, prevent themย happening altogether.โ€

Read more aboutย Manchesterโ€™s stroke researchย appeal.ย 

Find out more about theย Natalie Kate Moss Trust.

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