Cerebral amyloid angiopathy and intracerebral haemorrhage: community-based cohort study, biobank, and record linkage

Lead Research Organisation: University of Edinburgh
Department Name: Sch of Molecular. Genetics & Pop Health

Abstract

This research is about cerebral amyloid angiopathy, which is known as ‘CAA‘ for short. In CAA, a protein gradually damages blood vessels in the brain. CAA can be found in elderly people who are healthy, who have dementia, or who have stroke due to brain haemorrhage.
This research aims to find out how CAA causes brain haemorrhages, how to recognise CAA in people with brain haemorrhage before they die, and what predicts whether someone who survives brain haemorrhage might have another one.
The research will: (1) recruit adults with brain haemorrhage in one community, (2) obtain consent to collect information about them, their brain scans and their brain tissue, (3) compare them to people without brain haemorrhage in another MRC study, (4) compare different types of brain haemorrhage to eachother, and (5) study the outcome after different types of brain haemorrhage in one country.
This research might benefit patients by finding out why brain haemorrhage happens, how to recognise its cause, and who is most likely to have it again. This could help identify ways of preventing brain haemorrhage in future, which will become more common as the population ages. Studying ageing is one of the MRC‘s two research priorities.

Technical Summary

Background: Spontaneous intracerebral haemorrhage (ICH) affects ~1.5 million adults in the world each year. Unlike ischaemic stroke, the incidence of ICH is not declining and does not have specific treatments. Most ICH occurs in people aged ?70 years, and ICH incidence is likely to rise in ageing societies. Deposition of amyloid in cerebral vessel walls, known as cerebral amyloid angiopathy (CAA), is more common with age and in people with dementia. CAA is often inferred to be the cause of ICH in the brain‘s lobes, but the strength of the association between CAA and lobar ICH, the causal pathway(s), accuracy of diagnostic criteria for ICH due to CAA, and best preventive strategies are unclear.
Aim: To better understand how CAA causes ICH, develop diagnostic criteria to identify patients who have CAA underlying ICH, and determine factors influencing prognosis. This stratified medicine approach will inform the design of secondary prevention trials. The objective is to promote healthy ageing (an MRC research priority theme).
Design: Community-based ICH biobank, nested within a population-based study.
Methods:
(1) Using multiple, overlapping sources of case ascertainment I will find incident cases of ICH in a community-based cohort study, and create a biobank of clinical and radiographic data and brain tissue (44% consented to donation so far). I will investigate the association between CAA and lobar ICH in case-control comparisons with the community-based MRC Cognitive Function and Ageing Study (CFAS). I will determine the accuracy of different diagnostic criteria for CAA associated with lobar ICH in my community-based ICH study, using blinded comparisons of clinical criteria, imaging, and cerebrospinal fluid biomarkers to an autopsy reference standard.
(2) I will establish two novel record linkages, from a Scottish population-based ICH dataset to national prescribing data and digital brain images, to perform multivariable analyses of clinical, imaging, and therapeutic influences on prognosis after ICH. Estimates of treatment effect and potential recruitment rates will help design trials to improve ICH outcome.
Scientific and medical opportunities:
Unique ability to link population-wide clinical, brain imaging and prescribing data.
Efficient and cost-effective methods using existing NHS data and international collaborations.
Expertise in my institution in stroke medicine, brain banking, brain imaging, epidemiological methods, trials methodology research, and nurturing and training clinical academics.
Promising recruitment and tissue donation rates to my community-based ICH biobank.
Data and tissue collected will enable me to take a stratified approach to deep ICH.

Publications

10 25 50

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Agarwal PK (2012) Delayed diagnosis of oculopharyngeal muscular dystrophy in Scotland. in The British journal of ophthalmology

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Al-Shahi Salman R (2016) Dementia after stroke due to intracerebral haemorrhage. in The Lancet. Neurology

 
Guideline Title Cerebral arteriovenous malformation
Description AVM review cited by BMJ Best Practice
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in clinical guidelines
Impact Effective use of diagnostic and therapeutic techniques for brain arteriovenous malformations
 
Description Academy of Medical Sciences INSPIRE lead for Edinburgh
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
Impact I run this scheme to promote the involvement of medical students in research
 
Description Appointment to American Heart Association guidelines committee for arteriovenous malformations of the brain
Geographic Reach North America 
Policy Influence Type Membership of a guidance committee
Impact Authorship of guidelines that will discourage the use of treatments that I showed in a recent clinical trial and population-based cohort to cause a three-fold increase in the risk of stroke in comparison to no treatment.
 
Description Arthur Fonville prize award
Geographic Reach Europe 
Policy Influence Type Influenced training of practitioners or researchers
Impact The prize was awarded to a student from Edinburgh University who had conducted a pilot study of the Nrf2 pathway after intracerebral haemorrhage by comparing Nrf2 activity in ICH cases vs. controls (who had died suddenly of causes unrelated to stroke). He demonstrated that the Nrf2 pathway was significantly less active in cases compared to controls. This pilot study contributed to the successful funding application for a programme grant.
URL https://www.ed.ac.uk/clinical-brain-sciences/news/news-jul-dec-2018/winners-arthur-fonville-award-20...
 
Description BASP Strategic plan 2021-2024
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
Impact Rustam to complete - didnt want to tick 'no impacts yet'
URL https://www.basp.org/whatwedo/
 
Description BASP scientific committee
Geographic Reach National 
Policy Influence Type Influenced training of practitioners or researchers
Impact Educational activities for UK stroke physicians and neurologists
 
Guideline Title Guidelines for the use of platelet transfusions
Description British Committee for Standards in Haematology
Geographic Reach National 
Policy Influence Type Citation in clinical guidelines
Impact Avoidance of the use of platelet transfusion, which was shown to be harmful in this randomised trial
URL http://onlinelibrary.wiley.com/doi/10.1111/bjh.14423/full
 
Description British Neurological Surveillance Unit
Geographic Reach National 
Policy Influence Type Participation in advisory committee
 
Description Cavernoma management guidelines
Geographic Reach Multiple continents/international 
Policy Influence Type Membership of a guidance committee
Impact These are the first ever guidelines for the management of adults with cerebral cavernous malformations
URL http://www.cavernoma.org.uk/opus452.html
 
Guideline Title 2017 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways
Description Citation in 2017 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants: A Report of the American College of Cardiology Task Force on Expert Consensus Decision Pathways
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in clinical guidelines
Impact The trial showed harm from platelet transfusion, so less use of the intervention will improve survival
 
Guideline Title European Stroke Organisation (ESO) guidelines for the management of spontaneous intracerebral hemorrhage
Description Citation in European Stroke Organisation (ESO) guidelines for the management of spontaneous intracerebral hemorrhage
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in clinical guidelines
Impact Importance of avoidance of haemostatic drugs in spontaneous ICH not associated with antithrombotic drug use
 
Guideline Title Cavernoma-related epilepsy: Review and recommendations for management - Report of the Surgical Task Force of the ILAE Commission on Therapeutic Strategies
Description Citation in International League Against Epilepsy guidelines
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in clinical guidelines
Impact The risk of epilepsy after a first seizure relating to a cavernous malformation is so high that anti-epileptic drugs should be started without waiting for the second seizure
 
Guideline Title Guidelines for the Clinical Management of Cerebral Cavernous Malformations: Consensus Recommendations Based on Systematic Literature Review by the Angioma Alliance Scientific Advisory Board Clinical Experts Panel
Description Citation in cavernoma clinical guidelines
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in clinical guidelines
Impact Informs healthcare
URL https://academic.oup.com/neurosurgery/article/80/5/665/3106453
 
Guideline Title Guidelines for the use of platelet transfusions
Description Citation in guidelines for the use of platelet transfusions
Geographic Reach National 
Policy Influence Type Citation in clinical guidelines
Impact The trial showed worse survival after platelet transfusion, so less use of the intervention will save lives
 
Description Development and implementation of NHS Lothian Intracerebral Haemorrhage 'ACT' guidance
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Influenced training of practitioners or researchers
Impact Educated healthcare workers about best evidence for patient management. Changed the way that radiologists report brain scans.
 
Description European guidelines on intracerebral haemorrhage
Geographic Reach Multiple continents/international 
Policy Influence Type Membership of a guidance committee
Impact Guidance to practitioners based on the best available evidence in clinical trials.
URL http://onlinelibrary.wiley.com/store/10.1111/ijs.12309/asset/ijs12309.pdf?v=1&t=i20li2eq&s=ec8a26db9...
 
Description Shaping stroke research to rebuild lives: The Stroke Priority Setting Partnership results for investment
Geographic Reach National 
Policy Influence Type Participation in a national consultation
URL https://www.stroke.org.uk/sites/default/files/research/stroke_priority_setting_partnership_full_repo...
 
Description Stereotactic radiosurgery alone or combined with embolization for brain arteriovenous malformations: a systematic review and meta-analysis
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in systematic reviews
 
Description Stroke Research Network Prevention Clinical Studies Group
Geographic Reach National 
Policy Influence Type Participation in advisory committee
Impact I was elected to the UK Stroke Research Network Prevention Clinical Studies Group to influence which research projects should be conducted in the UK
 
Description Synopsis of Guidelines for the Clinical Management of Cerebral Cavernous Malformations: Consensus Recommendations Based on Systematic Literature Review by the Angioma Alliance Scientific Advisory Board Clinical Experts Panel
Geographic Reach Multiple continents/international 
Policy Influence Type Membership of a guideline committee
 
Description 18F-Flutemetamol for the ante mortem recognition of intracerebral haemorrhage due to cerebral amyloid angiopathy
Amount £51,000 (GBP)
Organisation GE Healthcare Limited 
Sector Academic/University
Country United Kingdom
Start 06/2016 
End 06/2018
 
Description A research dedicated 3 Tesla Magnetic Resonance (MR) Scanner
Amount £300,000 (GBP)
Funding ID R380R/1114 
Organisation The Dunhill Medical Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 05/2016 
End 08/2016
 
Description Alzheimer's Research UK Global Clinical Trials Fund
Amount £155,069 (GBP)
Funding ID ARUK-GCTF2016B-2 
Organisation Alzheimer's Research UK 
Sector Charity/Non Profit
Country United Kingdom
Start 08/2016 
End 08/2018
 
Description BHF clinical research training fellowship
Amount £168,553 (GBP)
Funding ID FS/17/53/33119 
Organisation British Heart Foundation (BHF) 
Sector Charity/Non Profit
Country United Kingdom
Start 01/2018 
End 12/2020
 
Description Cavernomas A Randomised Effectiveness (CARE) pilot trial to address the effectiveness of active treatment (with neurosurgery or stereotactic radiosurgery) versus conservative management in people with symptomatic brain cavernoma
Amount £973,836 (GBP)
Funding ID NIHR128694 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 08/2020 
End 08/2023
 
Description Desmopressin for treatment of patients taking Antiplatelet agents with Stroke due to Haemorrhage
Amount £286,801 (GBP)
Funding ID PB-PG-0816-20011 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 05/2018 
End 12/2020
 
Description Edinburgh Clinical Academic Track clinical research training fellowship
Amount £155,000 (GBP)
Organisation Wellcome Trust 
Department Wellcome Trust Research Training Fellowship
Sector Charity/Non Profit
Country United Kingdom
Start 12/2015 
End 11/2018
 
Description Edinburgh Clinical Academic Track clinical research training fellowship for James Loan
Amount £229,853 (GBP)
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 07/2018 
End 08/2021
 
Description Edinburgh Translational Neuroscience PhD student
Amount £152,059 (GBP)
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 07/2018 
End 07/2021
 
Description INSPIRE
Amount £9,250 (GBP)
Organisation Academy of Medical Sciences (AMS) 
Sector Charity/Non Profit
Country United Kingdom
Start 03/2013 
End 03/2014
 
Description INSPIRE: The intercalated degree: in a nutshell
Amount £4,950 (GBP)
Organisation Academy of Medical Sciences (AMS) 
Sector Charity/Non Profit
Country United Kingdom
Start 07/2015 
End 07/2017
 
Description Long-term outcomes in unruptured brain arteriovenous malformation patients
Amount $675,224 (USD)
Funding ID R01NS099268 
Organisation National Institutes of Health (NIH) 
Department National Institute of Neurological Disorders and Stroke (NINDS)
Sector Public
Country United States
Start 04/2017 
End 04/2022
 
Description MRC / Stroke Association clinical training fellowship (Neshika Samarasekera)
Amount £202,356 (GBP)
Funding ID G0900428 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 02/2010 
End 02/2013
 
Description MRC / The Stroke Association programme grant (Capital Investment in Human Tissue Banking and Linked Data in Partnership with Charities)
Amount £559,445 (GBP)
Funding ID MR/R014140/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 08/2017 
End 12/2021
 
Description MRC Confidence in Concept scheme
Amount £81,011 (GBP)
Funding ID MRC/CIC2/015 
Organisation University of Edinburgh 
Sector Academic/University
Country United Kingdom
Start 09/2014 
End 07/2016
 
Description MRI evaluation of effects of tranexamic acid in spontaneous intracerebral haemorrhage: The TICH-2 MRI study
Amount £298,962 (GBP)
Funding ID PG/14/96/31262 
Organisation British Heart Foundation (BHF) 
Sector Charity/Non Profit
Country United Kingdom
Start 07/2015 
End 07/2017
 
Description Magnetic Resonance Imaging of Lifecourse Influences on Brain Health and Disease.
Amount £600,000 (GBP)
Funding ID 104916 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 01/2015 
End 12/2019
 
Description NHS Research Scotland Fellowship -Neshika Samarasekera
Amount £68,438 (GBP)
Organisation Chief Scientist Office 
Sector Public
Country United Kingdom
Start 03/2018 
End 04/2021
 
Description National Health and Medical Research Council project grant
Amount $5,311,292 (AUD)
Funding ID APP1103886 
Organisation National Health and Medical Research Council 
Sector Public
Country Australia
Start 06/2016 
End 06/2021
 
Description Part-funding for a research-dedicated 3 Tesla Magnetic Resonance (MR) Scanner
Amount £300,000 (GBP)
Funding ID R380R/1114 
Organisation The Dunhill Medical Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 12/2015 
End 12/2015
 
Description Pathomolecular mechanisms of intracerebral haemorrhage: functional analysis of collagen IV variants.
Amount £705,869 (GBP)
Funding ID MR/R005567/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 07/2018 
End 12/2021
 
Description Prevention Of Hypertensive Injury to the Brain by Intensive Treatment after IntraCerebral Haemorrhage (PROHIBIT ICH): a pilot randomized trial of home telemetry-guided treatment
Amount £448,144 (GBP)
Funding ID PPA2015/04 
Organisation Stroke Association 
Sector Charity/Non Profit
Country United Kingdom
Start 05/2016 
End 05/2019
 
Description Prevention Of Hypertensive Injury to the Brain by Intensive Treatment after IntraCerebral Haemorrhage: a pilot randomized trial of home telemetry-guided treatment
Amount £448,144 (GBP)
Funding ID PPA2015/04 
Organisation Stroke Association 
Sector Charity/Non Profit
Country United Kingdom
Start 02/2017 
End 02/2020
 
Description Research Excellence (round 3)
Amount £3,000,000 (GBP)
Funding ID RE/18/5/34216 
Organisation British Heart Foundation (BHF) 
Sector Charity/Non Profit
Country United Kingdom
Start 03/2019 
End 03/2024
 
Description Role of 18F-Fluoride imaging as a novel marker of plaque instability
Amount £251,525 (GBP)
Funding ID PG/12/8/29371 
Organisation British Heart Foundation (BHF) 
Sector Charity/Non Profit
Country United Kingdom
Start 07/2012 
End 07/2016
 
Description STATINS USE IN INTRACEREBRAL HEMORRHAGE PATIENTS (SATURN)
Amount $3,014,650 (USD)
Funding ID U01NS102289 
Organisation National Institutes of Health (NIH) 
Department National Institute of Neurological Disorders and Stroke (NINDS)
Sector Public
Country United States
Start 08/2019 
End 05/2026
 
Description Start or STop Anticoagulants Randomised Trial (SoSTART) for atrial fibrillation after intracranial haemorrhage: safety phase
Amount £721,223 (GBP)
Funding ID CS/18/2/33719 
Organisation British Heart Foundation (BHF) 
Sector Charity/Non Profit
Country United Kingdom
Start 07/2018 
End 07/2021
 
Description Stroke Association postgraduate fellowship (Katie McGoohan)
Amount £105,000 (GBP)
Funding ID TSA Postgrad 2014/02 
Organisation Stroke Association 
Sector Charity/Non Profit
Country United Kingdom
Start 08/2014 
End 08/2017
 
Description The Stroke Association Haemorrhagic Stroke Priority Programme Award
Amount £449,482 (GBP)
Funding ID TSAPPA2017/01 
Organisation Stroke Association 
Sector Charity/Non Profit
Country United Kingdom
Start 03/2018 
End 03/2022
 
Description Tranexamic acid for hyperacute primary Intracerebral Haemorrhage (TICH-2)
Amount £2,504,823 (GBP)
Funding ID 11/129/109 
Organisation National Institute for Health Research 
Department Health Technology Assessment Programme (HTA)
Sector Public
Country United Kingdom
Start 03/2013 
End 02/2017
 
Description Triple therapy prevention of Recurrent Intracerebral Disease EveNts Trial (TRIDENT)
Amount $5,311,292 (AUD)
Funding ID APP1103886 
Organisation National Health and Medical Research Council 
Sector Public
Country Australia
Start 06/2016 
End 06/2021
 
Description Wellcome Trust Biomedical Resource / Multi-User Equipment / Technology Development Grant
Amount £600,000 (GBP)
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 01/2016 
End 02/2016
 
Description Wellcome Trust Edinburgh Clinical Academic Track clinical research training fellowship
Amount £223,001 (GBP)
Funding ID 203699/Z/16/Z 
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 12/2015 
End 12/2018
 
Description what is the best brain imaging strategy for patients with suspected minor stroke or transient ischaemic attack (TIA)?
Amount £295,114 (GBP)
Funding ID TCS/17/08 
Organisation Chief Scientist Office 
Sector Public
Country United Kingdom
Start 07/2018 
End 01/2021
 
Title Biobank of data, imaging, and tissue from patients with intracerebral haemorrhage 
Description Community-based study of adults with intracerebral haemorrhage 
Type Of Material Biological samples 
Provided To Others? No  
Impact Collaboration with MRC Cognitive Function and Ageing Study in place for unique future analyses 
 
Title Creation of the REduce research Waste And Reward Diligence (REWARD) Alliance and Lancet REWARD campaign 
Description It has been estimated that 85% of research is wasted, usually because it asks the wrong questions, is badly designed, not published or poorly reported. This diminishes the value of research and also represents a significant financial loss. However, many causes of this waste are simple problems that could easily be fixed, such as appropriate randomisation or blinding of a clinical trial. A first step towards increasing the value of research and reducing waste is to monitor the problems and develop solutions that aim to fix them: the REWARD Alliance does exactly that. 
Type Of Material Improvements to research infrastructure 
Year Produced 2014 
Provided To Others? Yes  
Impact First REWARD Alliance conference, held jointly with the EQUATOR Network, in Edinburgh in September 2015. 
URL http://rewardalliance.net/
 
Title Edinburgh CT/APOE diagnostic criteria for intracerebral haemorrhage attributable to cerebral amyloid angiopathy 
Description The CT and APOE genotype prediction model for CAA-associated lobar intracerebral haemorrhage shows excellent discrimination in this cohort, but requires external validation. The Edinburgh rule-in and rule-out diagnostic criteria might inform prognostic and therapeutic decisions that depend on identification of CAA-associated lobar intracerebral haemorrhage. 
Type Of Material Physiological assessment or outcome measure 
Year Produced 2019 
Provided To Others? Yes  
Impact Multiple publications validating these criteria and exploring their clinical utility 
URL https://datashare.ed.ac.uk/handle/10283/2923
 
Title New diagnostic criteria for intracerebral haemorrhage associated with cerebral amyloid angiopathy 
Description Globally relevant diagnostic criteria, that only require a blood test and CT scan 
Type Of Material Physiological assessment or outcome measure 
Year Produced 2018 
Provided To Others? Yes  
Impact In use in clinical and research practice 
URL https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(18)30006-1/fulltext
 
Title Training module for the Edinburgh CT/APOE diagnostic criteria for intracerebral haemorrhage attributable to cerebral amyloid angiopathy 
Description ECCITING may help you to learn about how to read & rate CT brain scans in which haemorrhage is a finding. Participation also helps validate the Edinburgh criteria & collect data on its prognostic value. 
Type Of Material Physiological assessment or outcome measure 
Year Produced 2020 
Provided To Others? Yes  
Impact Researchers trained and certificates issued 
URL https://www.ed.ac.uk/clinical-sciences/edinburgh-imaging/education-teaching/short-courses/training-t...
 
Title Intracerebral haemorrhage trial simulator 
Description We have used the data from our community based inception cohort study to create an online simulator of recruitment to randomised trials in this disease. 
Type Of Material Database/Collection of data 
Year Produced 2013 
Provided To Others? Yes  
Impact Citation by other researchers and use of the simulator to design trials. 
URL http://www.dcn.ed.ac.uk/ichsimulator/
 
Description Collaboration with Amsterdam Medical Centre 
Organisation Academic Medical Center
Country Netherlands 
Sector Academic/University 
PI Contribution Intellectual input into clinical trial conduct and recruitment of patients.
Collaborator Contribution Initiation of randomised controlled trial.
Impact Ongoing trial
Start Year 2009
 
Description Collaboration with Beth Israel Deaconess Medical Center 
Organisation Beth Israel Deaconess Medical Center
Country United States 
Sector Hospitals 
PI Contribution I led a programme grant application to the Stroke Association, in collaboration with this group, and we were successful in being awarded £449,482
Collaborator Contribution Expertise on neuro-infalmmatory mechnanisms with therapeutic potential after ICH
Impact Intellectual collaboration for a grant application
Start Year 2017
 
Description Collaboration with Boston Haemorrhagic Stroke Research Programme 
Organisation Harvard University
Department Department of Neurobiology
Country United States 
Sector Academic/University 
PI Contribution I have generated the hypotheses, and designed the research programme
Collaborator Contribution Their collaboration has underpinned the development of my senior clinical fellowship application to MRC
Impact MRC senior clinical fellowship application
Start Year 2010
 
Description Collaboration with Division of Cardiovascular Sciences at The University of Manchester 
Organisation University of Manchester
Department Division of Cardiovascular Sciences
Country United Kingdom 
Sector Academic/University 
PI Contribution I led a programme grant application to the Stroke Association, in collaboration with this group, and were successful in being awarded £449,482
Collaborator Contribution Intellectual contribution on neuro-inflammatory mechanisms that we will study
Impact Multi-disciplinary collaboration for a grant application.
Start Year 2017
 
Description Collaboration with George Institute for Global Health 
Organisation George Institute for Global Health
Department Neurological and Mental Health Division
Country Australia 
Sector Charity/Non Profit 
PI Contribution Designed randomised controlled trial, which has been funded: National Health and Medical Research Council project grant. Triple therapy prevention of Recurrent Intracerebral Disease EveNts Trial (TRIDENT). Ref. APP1103886 (AUS$5,311,291.90)
Collaborator Contribution Led application: National Health and Medical Research Council project grant Triple therapy prevention of Recurrent Intracerebral Disease EveNts Trial (TRIDENT). Ref. APP1103886 (AUS$5,311,291.90)
Impact I was awarded a British Heart Foundation travel fellowship to pursue this collaboration, which still continues 5 years later, maturing grant applications for research that applies to current clinical practice
Start Year 2013
 
Description Collaboration with Institute of Neurology 
Organisation University College London
Department Institute of Neurology
Country United Kingdom 
Sector Academic/University 
PI Contribution Intellectual input
Collaborator Contribution Collaboration on current studies and obtaining funding for future research studies,
Impact Co-applicant on successful programme grant application to the BHF
Start Year 2009
 
Description Collaboration with Lille haemorrhagic stroke group 
Organisation Lille University Hospital
Department Department of Neurology
Country France 
Sector Hospitals 
PI Contribution Supervision of a postgraduate student, sharing data, leading on analyses
Collaborator Contribution Several publications using shared data
Impact Several publications
Start Year 2006
 
Description Collaboration with Mario Negri Institute for Pharmacological Research 
Organisation European Institute of Oncology (IEO)
Country Italy 
Sector Academic/University 
PI Contribution Trial steering committee member responsible for contributing to trial design of Propranolol in Cerebral Cavernous Malformation (Treat_CCM) (NCT03589014)
Collaborator Contribution Conduct of randomised trial
Impact Protocol publication pending
Start Year 2018
 
Description Collaboration with Nottingham University 
Organisation University of Nottingham
Department School of Medicine
Country United Kingdom 
Sector Academic/University 
PI Contribution Member of Trial Steering Committee and NIHR HTA project grant co-applicant
Collaborator Contribution Lead on trial grant application
Impact NIHR HTA successful grant application
Start Year 2011
 
Description Collaboration with the International Stroke Genetics Consortium 
Organisation Massachusetts General Hospital
Department International Stroke Genetics Consortium
Country United States 
Sector Hospitals 
PI Contribution Contribution of DNA for GWAS analyses.
Collaborator Contribution Analysis of SNPs and statistical analysis.
Impact Publications
Start Year 2015
 
Description Collaboration with the MRC Cognitive Function and Ageing Study 
Organisation University of Cambridge
Department Department of Public Health and Primary Care
Country United Kingdom 
Sector Academic/University 
PI Contribution I have designed the study that we will do in collaboration.
Collaborator Contribution It is a globally unique comparison group for one of my research projects
Impact None so far
Start Year 2010
 
Description Collaboration with the Oxford Vascular Study 
Organisation Oxford University Hospitals NHS Foundation Trust
Department NIHR Oxford Biomedical Research Centre
Country United Kingdom 
Sector Academic/University 
PI Contribution We led on the data analysis
Collaborator Contribution Joint analysis of our two cohorts, resulting in a publication in Brain
Impact Publication in Brain, Pub Med ID 19042932
Start Year 2007
 
Description Collaboration with the UCL INSTITUTE OF NEUROLOGY stroke research centre 
Organisation University College London
Country United Kingdom 
Sector Academic/University 
PI Contribution Intellectual contribution to successful grant applications: The Stroke Association Priority Programme Award: Prevention Of Hypertensive Injury to the Brain by Intensive Treatment after IntraCerebral Haemorrhage (PROHIBIT ICH): a pilot randomized trial of home telemetry-guided treatment. Ref. PPA2015/04 and Stroke Association/British Heart Foundation Joint Programme Grant: Microbleeds and genetic risk factors to predict the risk of intracranial haemorrhage in patients treated with anticoagulation following cardioembolic stroke due to AF. Ref. TSA/BHF 2009/01
Collaborator Contribution Led grant applications
Impact Several publications
Start Year 2009
 
Description Collaboration with the University of Glasgow 
Organisation University of Glasgow
Department Institute of Cardiovascular and Medical Sciences
Country United Kingdom 
Sector Academic/University 
PI Contribution Collaboration that culminated in a £875,116 Medical Research Council Neurosciences and Mental Health Board project grant: Pathomolecular mechanisms of intracerebral haemorrhage: functional analysis of collagen IV variants Ref. MR/R005567/1
Collaborator Contribution They led the application, which relies on using tissue and DNA from my intracerebral haemorrhage brain bank
Impact £875,116 grant application
Start Year 2016
 
Description External advisory board to EDAN 
Organisation Erasmus University Rotterdam
Department Department of Epidemiology
Country Netherlands 
Sector Academic/University 
PI Contribution Invited to join external advisory board of the Early Detection of Alzheimer's Network
Collaborator Contribution Instigators of this collaboration
Impact None yet.
Start Year 2012
 
Description External advisory board to EDAN 
Organisation Leiden University Medical Center
Country Netherlands 
Sector Academic/University 
PI Contribution Invited to join external advisory board of the Early Detection of Alzheimer's Network
Collaborator Contribution Instigators of this collaboration
Impact None yet.
Start Year 2012
 
Description External advisory board to EDAN 
Organisation Massachusetts General Hospital
Department Hemorrhagic Stroke Research Programme
Country United States 
Sector Hospitals 
PI Contribution Invited to join external advisory board of the Early Detection of Alzheimer's Network
Collaborator Contribution Instigators of this collaboration
Impact None yet.
Start Year 2012
 
Description Health Research Authority 
Organisation NHS England
Department National Research Ethics Service
Country United Kingdom 
Sector Public 
PI Contribution Design of research studies to improve the efficiency and minimise waste in the assessment of applications to research ethics committees.
Collaborator Contribution The partner governs this activity in the UK.
Impact Research study underway
Start Year 2010
 
Description Investigator sponsored study with GE Healthcare 
Organisation General Electric
Department Neurosciences; GE Healthcare
Country United Kingdom 
Sector Private 
PI Contribution Intellectual design of protocol.
Collaborator Contribution Provision of radiotracer and funding for PET scans
Impact None yet
Start Year 2015
 
Description Member of the steering group of The Stroke Association's James Lind Alliance Priority Setting Partnership for stroke 
Organisation Stroke Association
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Input into design and conduct
Collaborator Contribution Organisation and funding
Impact Top ten priorities for stroke research pending
Start Year 2019
 
Description PATCH collaboration with AMC 
Organisation Academic Medical Center
Country Netherlands 
Sector Academic/University 
PI Contribution Membership of trial steering committee
Collaborator Contribution Lead on randomised controlled trial
Impact Successful Chest Heart & Stroke Scotland project grant application
Start Year 2009
 
Description Partnership with the Farr Institute 
Organisation Farr Institute of Health Informatics Research
Country United Kingdom 
Sector Academic/University 
PI Contribution Intellectual design of a system for routinely obtaining imaging from the National Picture Archiving Communications System (PACS) of NHS Scotland
Collaborator Contribution Information governance and architecture
Impact A prototype of the tool has been used recently in a collaboration, automating the collection of imaging for an identified cohort, which previously had been a labour intensive manual process. The imaging of the cohort will be used to investigate the development an automated software application that will identify stroke. Regulatory approvals for this process to happen in NHS Lothian. This work has supported a funding applications to the British Heart Foundation. Also this tool, or the knowledge gained developing it will support a service currently being developed by the Farr@Scotland, which will be used by funded research projects. An oral presentation titled "Establishing the 'Missing Linkage' with Imaging in Scottish Health Data: A Pilot for Intracerebral Haemorrhage" was given at The Farr Institute International Conference 2015. A basic software tool has been developed which will be improved by a continuing development program. The knowledge gained during the tool development has provide information that has contributed to the provision of a research PACS at the Farr@Scotland.
Start Year 2011
 
Description SATURN trial 
Organisation Beth Israel Deaconess Medical Center
Country United States 
Sector Hospitals 
PI Contribution This is a multi-center, pragmatic, prospective, randomized, open-label, and blinded end-point assessment (PROBE) clinical trial. A total of 1,456 patients presenting within 7 days of a spontaneous lobar ICH while taking statins will be randomized to one of two treatment strategies:discontinuation vs. continuation (restarting) of statin therapy (using the same agent and dose that they were using at ICHonset). Randomization will take into account: clinical site, statin dose and indication (primary vs. secondary prevention), current use or intent-to-use oral anticoagulants (OAC) and/or antiplatelets in the long-term post-ICH, and severity of ICH upon presentation as assessed by baseline ICH volume. Participating subjects will undergo baseline testing for APOE genotype and will be followed for 24 months to assess for the occurrence of recurrent symptomatic ICH or MACCE during the follow-up period.
Collaborator Contribution This is a multi-center, pragmatic, prospective, randomized, open-label, and blinded end-point assessment (PROBE) clinical trial. A total of 1,456 patients presenting within 7 days of a spontaneous lobar ICH while taking statins will be randomized to one of two treatment strategies:discontinuation vs. continuation (restarting) of statin therapy (using the same agent and dose that they were using at ICHonset). Randomization will take into account: clinical site, statin dose and indication (primary vs. secondary prevention), current use or intent-to-use oral anticoagulants (OAC) and/or antiplatelets in the long-term post-ICH, and severity of ICH upon presentation as assessed by baseline ICH volume. Participating subjects will undergo baseline testing for APOE genotype and will be followed for 24 months to assess for the occurrence of recurrent symptomatic ICH or MACCE during the follow-up period.
Impact No outcomes yet
Start Year 2021
 
Description Scientific Advisory Board for the CAA Foundation 
Organisation Dutch Cerebral Amyloid Angiopathy Foundation
Country Netherlands 
Sector Charity/Non Profit 
PI Contribution Developing a research agenda for the condition in collaboration with patients and carers
Collaborator Contribution They initiated it.
Impact Priority Setting Partnership initiated
Start Year 2014
 
Description UCSF Center for Cerebrovascular Research 
Organisation University of California, San Francisco
Department Center for Cerebrovascular Research
Country United States 
Sector Academic/University 
PI Contribution Intellectual contribution to design of a randomised controlled trial
Impact Applying to NIH as co-PI for funding of a randomised trial
Start Year 2010
 
Description USA Angioma Alliance Scientific Advisory Board 
Organisation Angioma Alliance
Country United States 
Sector Charity/Non Profit 
PI Contribution Advice on scientific strategy. Authoring of guidance documents
Collaborator Contribution Access to network of researchers and opportunity to create consensus guidelines
Impact Publication of guidelines for the definition of haemorrhage from cerebral cavernous malformations
Start Year 2007
 
Title RESTART trial 
Description REstart or STop Antithrombotics Randomised Trial (RESTART), a BHF-funded RCT to assess whether patients with intracerebral haemorrhage should continue or stop antithrombotic drugs after spontaneous intracerebral haemorrhage 
Type Therapeutic Intervention - Drug
Current Stage Of Development Wide-scale adoption
Year Development Stage Completed 2012
Development Status Under active development/distribution
Clinical Trial? Yes
Impact Pragmatic phase four RCT which will influence practice 
URL http://www.RESTARTtrial.org
 
Title Start or STop Anticoagulants Randomised Trial (SoSTART) 
Description Chest Heart and Stroke Scotland funding obtained for a pilot trial of oral anticoagulants after stroke due to intracerebral haemorrhage. 
Type Therapeutic Intervention - Drug
Current Stage Of Development Late clinical evaluation
Year Development Stage Completed 2017
Development Status Under active development/distribution
Clinical Trial? Yes
Impact International collaboration to address this therapeutic dilemma. 
URL http://www.sostart.ed.ac.uk
 
Title Intracerebral haemorrhage trial simulator 
Description This website is intended to help researchers designing studies of adults with spontaneous (non-traumatic) intracerebral haemorrhage (ICH), particularly randomised controlled trials of treatments. The website provides estimates of the proportion of patients with ICH who might be eligible for a trial, based on chosen selection criteria. The simulator will help assess the impact of eligibility criteria on the generalisability and feasibility of a trial. 
Type Of Technology Webtool/Application 
Year Produced 2013 
Impact Improved design and inclusiveness of clinical trials into intracerebral haemorrhage 
URL http://www.dcn.ed.ac.uk/ICHsimulator/
 
Description "Senior career opportunites post CCT" talk at Scottish Medical Education Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Health professionals
Results and Impact "Senior career opportunites post CCT" talk at Scottish Medical Education Conference

Inspiring colleagues to pursue careers in academic medicine
Year(s) Of Engagement Activity 2013
URL http://www.rcpsg.ac.uk/~/media/Files/News/3rd%20National%20Scottish%20Medical%20Education%20Conferen...
 
Description 14th International ATRIUM conference - 12 March 2022 'Thriving on failure: the highs and lows of being a clinical academic' 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Talk to upcoming doctors on the benefits and drawbacks of a career in clinical academia.
Year(s) Of Engagement Activity 2022
URL https://doctorsacademy.org/coursenw/NAIC/?fbclid=IwAR1DULQSWCadryRd-PfQ9xi38U7Z3qOMZt-JPHhZX-NZlchaY...
 
Description 15th China Neurology forum: 8 reasons to be ASPIRING (Antiplatelet Secondary Prevention International Randomised trial after INtracerebral haemorrhaGe) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact 8 reasons to be ASPIRING (Antiplatelet Secondary Prevention International Randomised trial after INtracerebral haemorrhaGe)
Year(s) Of Engagement Activity 2021
 
Description 1st Congress of the European Academy of Neurology, Berlin, Germany 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited speaker at teaching course: 1st Congress of the European Academy of Neurology, Berlin, Germany
Year(s) Of Engagement Activity 2015
 
Description 1st World AVM conference 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact I co-organised the first ever world AVM congress attended by 300 doctors from all over the world

Greater awareness of neurological issues for patients
Year(s) Of Engagement Activity 2012
 
Description 2011 CCM workshop 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation of the first clinical guidelines for adults with cavernous malformations

Disseminated at Society of British Neurological Surgeons conference and prompted an invitation to speak at their subsequent meeting
Year(s) Of Engagement Activity 2011
 
Description @BleedingStroke Twitter feed 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Hundreds of people follow my Twitter feed about matters relating to stroke due to haemorrhage
Year(s) Of Engagement Activity 2014,2015,2016
URL https://twitter.com/BleedingStroke
 
Description Arthur Fonville Award 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Supporters
Results and Impact This is an award for a 1,500-3,000 word dissertation summarising a research project into any aspect of stroke, conducted by a medical student in year 3 to 6 at the University of Edinburgh or the University of Amsterdam. There is a prize of £100 for the best entry from each country, plus the opportunity of a further award of up to £750 to support attendance at a conference to present the research in the year after the award. This posthumous award was established in memory of Arthur Fonville, a medical student from the University of Amsterdam, who worked with the Research to Understand Stroke due to Haemorrhage (RUSH) team in Edinburgh 2011-2013, and died in September 2014.
Year(s) Of Engagement Activity 2021
URL https://www.ed.ac.uk/clinical-brain-sciences/research/rush-research-group-overview/arthur-fonville-a...
 
Description Association of British Neurologists keynote lecture: Covid-19 and the nervous system 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Evidence-based review of COVID-19 and the nervous system
Year(s) Of Engagement Activity 2020
URL https://www.sbns.org.uk/index.php/conferences/diary/sbns-unlocked-meeting-23-october-2020/
 
Description BASP memberhsip of the Stroke Alliance for Europe 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Rustam to complete
Year(s) Of Engagement Activity 2020
URL https://www.safestroke.eu/
 
Description BBC news article about RESTART trial result 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact BBC news article - amongst many other media articles - disseminating the results of the RESTART trial
Year(s) Of Engagement Activity 2019
URL https://www.bbc.co.uk/news/health-48349792
 
Description BMJ Masterclass in Stroke 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Sell out audience of 120 consultants and trainees at BMJ Masterclass in Stroke in London. I was rated the top speaker.

Publicisation of best practice in managing brain haemorrhage, and opportunities to do research to improve future care. Subsequent contact from budding stroke researchers and questions about clinical management.
Year(s) Of Engagement Activity 2013,2014,2015,2016
URL http://masterclasses.bmj.com
 
Description Brain imaging - friend or foe 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact EMERGE 10: Celebrating ten years in Emergency Medical Reseach
Year(s) Of Engagement Activity 2018
 
Description British Neurosurgical Research Group 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact CARE trial output
Year(s) Of Engagement Activity 2019
 
Description Can Brain CT Diagnose Intracerebral Haemorrhage Due to Cerebral Amyloid Angiopathy? European Stroke conference 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact ESOC is the leading forum in Europe for advances in research and clinical care of patients with cerebrovascular diseases, as demonstrated by the huge attendance at ESOC 2019, and an increasing number of abstracts submitted year on year, with more than 3050 abstracts received in 2020, our joint meeting with WSO, being the largest yet.
Year(s) Of Engagement Activity 2021
URL https://eso-conference.org
 
Description Can we diagnose CAA without MRI? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Leuven University, Belgium
Year(s) Of Engagement Activity 2018
 
Description Centre for Research into Evidence-Based Practice (Gold Coast, Australia) invited talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact 3-day research visit and invited talk, to stimulate the next phase of my research programme and collaborative work.

I was asked to talk to a Melbourne newspaper for a feature article on my research
Year(s) Of Engagement Activity 2014
 
Description Clinical Neurosciences grand round New Mexico - Is antiplatelet therapy safe and effective after stroke due to intracerebral hemorrhage (ICH)? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Clinical Neurosciences grand round New Mexico
Year(s) Of Engagement Activity 2021
 
Description Co-organiser and speaker at the first UK Stroke Research Workshop, Cambridge 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Talk: "Intracerebral haemorrhage: what's know and what's not"
Year(s) Of Engagement Activity 2017
 
Description Cochrane Stroke Group Editorial Board meeting 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presented recently-published findings by Tamborska et al on randomised trial quality
Year(s) Of Engagement Activity 2018
 
Description Comment on Hilkens et al 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Post-stroke antiplatelet bleeding risk estimated in new model (CME/CE)
MedPage Today (USA) (International)
Year(s) Of Engagement Activity 2017
URL https://www.medpagetoday.com/neurology/strokes/67026
 
Description Congress of the Neurological Association of South Africa 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Incidental findings on brain imaging: is prevention better than cure?
Year(s) Of Engagement Activity 2020
URL https://www.nasacongresses.co.za/index.php/programme
 
Description Congress of the Neurological Association of South Africa 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Increasing value and reducing waste in neurosciences research (Ethics)
Year(s) Of Engagement Activity 2020
URL https://www.nasacongresses.co.za/index.php/programme
 
Description Congress of the Neurological Association of South Africa 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Antithrombotic drugs after stroke due to intracerebral haemorrhage: should we worry about bleeding or clotting?
Year(s) Of Engagement Activity 2020
URL https://www.nasacongresses.co.za/index.php/programme
 
Description Discussion led by Rustam Salman and Neil Kitchen as part of Brain Awareness week with Cavernoma Alliance UK members about the CARE study. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact As part of Brain Awareness week, Prof Salman will lead a live questions and answers session about the CARE study for Cavernoma Alliance UK members.
Year(s) Of Engagement Activity 2022
URL https://cavernoma.org.uk/events/
 
Description ESOC 2021 plenary presentation - Short term systolic BP variability and functional outcome after acute ICH analyses of pooled individual participant data 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Delivered the plenary presenation at ESOC 2021 presenting to data on the results of my research.
Year(s) Of Engagement Activity 2021
URL https://2021.eso-conference.org/scientific-programme/
 
Description Edinburgh Clinical Research Methodology Course 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact I co-organised this two-day clinical research methodology course, which attracted major international talent and 150 delegates.

Enhanced education of peers, helping advance career progression.
Year(s) Of Engagement Activity 2013
URL http://www.ecat.ed.ac.uk/research-methods/
 
Description Edinburgh International Science Festival talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? Yes
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact A growing trend toward MRI brain scanning is revealing a lot more than beautiful images of healthy brains. But how do neurologists decide when treatment is required and would we all benefit from a brain scanning programme? Join MRC Senior Clinical Fellow and Consultant Neurologist Rustam Al-Shahi Salman for a discussion on the issues as he reveals just how abnormal many of our normal brains really are.

Audience of over 100 people stimulated by talk, provoking questions from 7 to 70 year-olds!
Year(s) Of Engagement Activity 2013
URL http://www.sciencefestival.co.uk/whats-on/categories/talk/picturing-your-brain
 
Description European Stroke Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Invited speaker - Promotion of my research outputs and ongoing randomised controlled trial to >1,000 international delegates

More hospitals joined the RESTART randomised controlled trial
Year(s) Of Engagement Activity 2013,2014,2015,2016
URL http://www.eso-stroke.org/eso-stroke/esoc-meetings.html
 
Description European Stroke Organisation (ESO) conference, Prague meeting to plan the creation of an ESO Trials alliance 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Inaugural meeting to plan the ESO Trials alliance
Year(s) Of Engagement Activity 2017
 
Description European Stroke Organisation Stroke Research workshop - virtual lecture on 'Should your study be an observational study or a clinical trial?' 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Internationally recognised organisation engaging with stroke professionals worldwide. 2 day virtual event for all professional practitioners interested in furthering their knowledge of stroke and stroke research. Delivered with an Edinburgh faculty.
Year(s) Of Engagement Activity 2021
URL https://eso-stroke.org/events/eso-edinburgh-stroke-research-workshop-virtual-for-2021/
 
Description Executive committe member of Stroke Research Network 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact NRS SRN supports clinical trials and other well-designed studies that are feasible and fit the Chief Scientist Office (CSO) eligibility criteria. Our portfolio spans a broad range of high quality academic and commercial research activity covering all aspects of cerebrovascular disease including acute treatment, prevention and rehabilitation.
Year(s) Of Engagement Activity 2021
URL https://www.nhsresearchscotland.org.uk/research-areas/stroke/about-the-network
 
Description Gave a talk: Conundrums in Stroke to UK Stroke Forum 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact UK Stroke Forum

The UK Stroke Forum is the UK's largest multidisciplinary conference for stroke care professionals.
Year(s) Of Engagement Activity 2021
URL https://www.stroke.org.uk/professionals/uk-stroke-forum
 
Description Gave talk to LX International Congress, Cagliari Italy November 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact 60 YEARS OF EVOLUTION IN HOSPITAL NEUROSCIENCE
Multidisciplinary strategies for effective and efficient assistance even in critical situations

Gave a talk on: What is the evidence, what are the uncertainties in the treatment of cerebral haemorrhages
Year(s) Of Engagement Activity 2021
URL http://www.sno2021.snoitalia.org
 
Description Intercollegiate Stroke Working Group- RCP London 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact National working party group which meets to form policy for stroke guidelines in the UK
Year(s) Of Engagement Activity 2021
 
Description Invited speaker at Advanced Clinical Neurology Course 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Health professionals
Results and Impact 70 neurologists attended my talk to learn about whether a recently described condition is a real diagnostic entity or not.

Approached by a prospective clinical research fellow.
Year(s) Of Engagement Activity 2014
 
Description Invited speaker at Irish Institute of Clinical Neuroscience meeting, Londonderry 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Invited to speak at Irish Institute of Clinical Neuroscience meeting, Londonderry
Year(s) Of Engagement Activity 2015
 
Description Invited speaker at a conference: European Stroke Conference, Prague 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact "Secondary prevention after ICH"
Year(s) Of Engagement Activity 2017
 
Description Invited talk at Regional Neuroscience Centre, University Hospital Wales, Cardiff 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Invited to talk about recent research outputs at Regional Neuroscience Centre, University Hospital Wales, Cardiff
Year(s) Of Engagement Activity 2015
 
Description Invited talk on the Lancet Increasing Value and Reducing Waste series at the Centre for Kidney Research, Westmead Hospital 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Institutional response to The Lancet series

I was asked to talk to the New South Wales Director of Health about how they could reform research regulation
Year(s) Of Engagement Activity 2014
 
Description Invited talk on the Lancet Increasing Value and Reducing Waste series at the Florey Institute in Melbourne, Australia 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Conveyed recommendations from the Lancet Increasing Value and Reducing Waste series

Institutional recommendations made for Increasing Value and Reducing Waste
Year(s) Of Engagement Activity 2014
 
Description Invited talk to the Cairns Society of Adelaide on incidental findings on brain imaging 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Presentation of my research work with implications for practice.

Colleagues' education
Year(s) Of Engagement Activity 2014
 
Description Keynote speaker at 8th symposium of the Swiss Clinical Trial Organisation, Basel 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact "Adding value in clinical research - what was achieved and how to manage new challenges"
Year(s) Of Engagement Activity 2017
 
Description Keynote speaker at the British Society for Haematology annual conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The trials and tribulations of platelet transfusion for spontaneous ICH
Year(s) Of Engagement Activity 2017
 
Description Keynote speaker at the German Network for Evidence Medicine annual conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Increasing value and reducing waste in clinical research
Year(s) Of Engagement Activity 2017
 
Description Lecture to medicine of the elderly specialty trainees 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Regional training day, to inspire trainees to conduct stroke research
Year(s) Of Engagement Activity 2017
 
Description MRC Hubs for Trial Methodology Research, Trial Recruitment Working Group 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact I am a member of the MRC Hubs for Trial Methodology Research, Trial Recruitment Working Group, focussing on ways to improve recruitment to trials.
Year(s) Of Engagement Activity 2015,2016
 
Description MRI PET study 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Stroke patients help study into brain bleeding
Year(s) Of Engagement Activity 2017
URL http://www.bbc.co.uk/news/uk-scotland-edinburgh-east-fife-39454506
 
Description Media coverage of Edinburgh CAA criteria 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Combined blood and brain tests predict repeat stroke risk
Year(s) Of Engagement Activity 2018
URL http://www.bbc.co.uk/news/uk-scotland-edinburgh-east-fife-42636192
 
Description Medscape report on ReSTART presentation at ESOC 2021: New Data on Antithrombotics After ICH: Is There a Net Benefit? 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Media article discussing the presetations at ESOC on RESTART project:

RESTART Trial of Antiplatelet Drugs
Salman also presented extended follow-up results from a trial of the use of antiplatelet medication for patients who had
previously experienced ICH.
The RESTART trial involved 537 participants who had taken antithrombotic therapy for the prevention of occlusive vascular
disease when they developed ICH and for whom antithrombotic therapy was therefore discontinued.
The trial randomly assigned patients to begin antiplatelet therapy (choice of therapy left to the clinician) or to avoid antiplatelet
therapy.
The main results, published in 2019, suggested a reduced risk for recurrent ICH with antiplatelet therapy (adjusted HR, 0.51;
95% CI, 0.25 - 1.03; P = .06) after 2 years' follow-up.
Because of this result, some guidelines suggest that it may be reasonable to begin administering antiplatelet drugs to these
patients, Salman noted.
Salman reported on extended follow-up (a median of 3.4 years) in the RESTART trial. The results of the extended follow-up
were also published online in JAMA Neurology to coincide with the ESOC presentation.
The latest results show that the number of ICH events in the two arms of the study have evened out after longer-term followup.
The primary outcome of recurrent ICH affected 8.2% of those allocated to receive antiplatelet therapy, compared with 9.3% of
those allocated to avoid antiplatelet therapy (adjusted HR, 0.87; 95% CI, 0.49 - 1.55; P = .64).
A major vascular event occurred in 26.8% of the antiplatelet therapy group, vs 32.5% of those in the avoid antiplatelet group
(HR, 0.79; 95% CI, 0.58 - 1.08; P = .14).
Salman concluded that the effect of antiplatelet therapy was still promising in the extended follow-up with respect to recurrent
ICH and major vascular events. Two other small, randomized trials of the use of antiplatelet therapy after ICH are ongoing. A
collaborative meta-analysis is planned, but it is very unlikely that the results will be definitive, he noted.
To Medscape Medical News he added: "So there may be a clinically significant net benefit, but this was not statistically
significant in RESTART. A larger trial is needed."
Salman and his group are now planning a new study of this issue. A pilot phase of the ASPIRING trial has started. The
researchers are seeking funding to recruit more than 4000 patients.
Year(s) Of Engagement Activity 2021
URL https://www.medscape.com/viewarticle/958437
 
Description Member of the Steering Group for the Stroke Association's Priority Setting Partnership 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact • setting up a Steering Group (SG) that includes people affected by stroke and HSCPs, and some of the organisations that can reach out to them, and developing partnership relationships with other organisations;
• gathering questions that people affected by stroke and HSCPs think research should answer, through online survey and other methods, aiming to reach those people whose voice is seldom heard (e.g. black, Asian and minority ethnicities);
• checking the evidence base to see whether any of the questions have already been answered, and removing those;
• asking people affected by stroke and HSCPs to rank the remaining questions, usually through online survey; and
• at least one final workshop where people affected by stroke and HSCPs arrive at the top 25 questions through a consensus approach.
Year(s) Of Engagement Activity 2019
 
Description Member of the Working Group on Thrombosis of the European Society of Cardiology 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Member of the Working Group on Thrombosis of the European Society of Cardiology, producing a position paper on, "Bleeding prevention and antithrombotic strategies after bleeding in patients with coronary artery disease"
Year(s) Of Engagement Activity 2015,2016
 
Description Member of the committee adjudicating the Cochrane REWARD Prize 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Member of the committee adjudicating the Cochrane REWARD Prize
Year(s) Of Engagement Activity 2017
 
Description Multimedia information tools for public engagement about the RESTART trial result 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Multi-media presentations (video abstract, plain English summary) of RESTART trial results
Year(s) Of Engagement Activity 2019,2020
URL http://www.restarttrial.org/default.html
 
Description National Institute for Health Research 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Membership of a peer review committee
Year(s) Of Engagement Activity 2018
 
Description Neurosurgery department, Essen, Germany 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Discussion of the design of a randomised controlled trial that could be run in Germany
Year(s) Of Engagement Activity 2017
 
Description Organised a session at the British Cardiovascular Society meeting 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact BCS/British Association of Stroke Physicians
Thrombectomy for acute ischaemic stroke: a new role for the cardiologist?

Chairs
Prof Rustam Al-Shahi Salman
Prof Adrian Banning

Talks
Evidence for IV thrombolysis for acute ischaemic stroke Dr William Whiteley Biography
Evidence for thrombectomy for acute ischaemic stroke Prof Keith Muir Biography
Interventional neuroradiologists should deliver thrombectomy Prof Philip White
Interventional cardiologists should deliver thrombectomy Dr Iqbal Malik
Panel discussion
Year(s) Of Engagement Activity 2016
URL http://www.bcs.com/ProgrammeSessions/session_details.asp?SessionID=3454949
 
Description Participant newsletters 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Study participants or study members
Results and Impact Annual newsletters to participants

Improved participant satisfaction
Year(s) Of Engagement Activity 2006,2007,2008,2009,2010,2011,2012,2013,2014,2015,2016
 
Description Participation in a national Canadian initiative to boost stroke randomised trials (CoHESIVE Symposium) 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact CoHESIVE Symposium - talk about lessons from the BHF RESTART trial, to help the Canadian stroke network
Year(s) Of Engagement Activity 2017
 
Description Patient Reference Group meetings 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact When designing my sub-study, I involved a group of patient representatives (the RUSH Patient Reference Group (RUSH PRG)). The RUSH PRG is comprised of 3 stroke survivors, 2 women and 1 man, 2 of which have had an intracerebral haemhorrhage. They provided valuable assistance in the development of the study materials and have reviewed and commented upon the information sheet and consent forms for LINCHPIN COG.

We try to meet with the group once a year, where we keep them up-to-date with all ongoing projects and discuss any issues that arise in the undertaking of these studies.
Year(s) Of Engagement Activity 2014,2015
 
Description Patient focus group meeting 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Type Of Presentation Workshop Facilitator
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Patients provided feedback on design and materials for my research

Beneficial effect on content of information and favourable opinion from Research Ethics Committee
Year(s) Of Engagement Activity 2011,2012,2013,2014,2015,2016
 
Description Plenary presentation at European Stroke Conference 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Delivered a plenary presentation:

EFFECTS OF ANTIPLATELET THERAPY AFTER STROKE DUE TO INTRACEREBRAL HAEMORRHAGE: EXTENDED FOLLOW-UP OF THE RESTART OR STOP ANTITHROMBOTICS RANDOMISED TRIAL (RESTART) - Prof. Rustam Al-Shahi Salman, (UK)
Year(s) Of Engagement Activity 2021
URL https://2021.eso-conference.org/
 
Description Plenary session at European Stroke Conference 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Plenary session on:

EFFECTS OF LONG-TERM ORAL ANTICOAGULATION FOR ATRIAL FIBRILLATION AFTER SPONTANEOUS INTRACRANIAL HAEMORRHAGE: THE START OR STOP ANTICOAGULANTS RANDOMISED TRIAL (SOSTART) - Prof. Rustam Al-Shahi Salman, (UK)
Year(s) Of Engagement Activity 2021
URL https://2021.eso-conference.org/
 
Description Podcast for The Lancet Neurology about a research output 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Media (as a channel to the public)
Results and Impact 12-minute podcast about the findings of my paper in The Lancet Neurology, directly relevant to patient care.
Year(s) Of Engagement Activity 2015,2016
URL http://www.thelancet.com/laneur/audio
 
Description Poster presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Presented a poster outlining my research study (LINCHPIN-COG) to nurses at the Scottish Stroke Nurses Forum conference 2017- Life after stroke
Year(s) Of Engagement Activity 2017
 
Description Poster presentation delivered by Kirsty Harkness about the CARE study and progress to date. UK stroke forum 30/11-2/12/2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact To update on study progress and enhance the profile of the CARE study.
Year(s) Of Engagement Activity 2021
URL https://www.stroke.org.uk/professionals/uk-stroke-forum
 
Description Presentation by Neil Kitchen about the CARE study and progress to date. SBNS 30 March 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact To update on study progress and enhance the profile of the CARE study.
Year(s) Of Engagement Activity 2022
URL https://www.ed.ac.uk/usher/edinburgh-clinical-trials/our-studies/all-current-studies/care/care-study
 
Description Presentation delivered by Carole Turner and Peter Hutchinson about the CARE study and progress to date. British Neurosurguical Group meeting 26/11/2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact To update on study progress and enhance the profile of the CARE study.
Year(s) Of Engagement Activity 2021
URL https://www.ed.ac.uk/usher/edinburgh-clinical-trials/our-studies/all-current-studies/care/care-study
 
Description Presentation delivered by Conor Mallucci about the CARE study and progress to date. British Paediatric Neurosurgical Group meeting talk - 4th June 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact To update on study progress and enhance the profile of the CARE study.
Year(s) Of Engagement Activity 2021
 
Description Presentation delivered by Kirsty Harkness about the CARE study and progress to date. 12/11/2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact To update on study progress and enhance the profile of the CARE study.
Year(s) Of Engagement Activity 2021
URL https://www.ed.ac.uk/usher/edinburgh-clinical-trials/our-studies/all-current-studies/care/care-study
 
Description Presentation delivered by Kirsty Harkness about the CARE study and progress to date. UK stroke forum 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact To update on study progress and enhance the profile of the CARE study.
Year(s) Of Engagement Activity 2021
URL https://www.stroke.org.uk/professionals/uk-stroke-forum
 
Description Presentation delivered by Kirsty Harkness about the CARE study and progress to date.Talk delivered to clinicians at Aberdeen Royal Infirmary - 10Feb2022 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact To update on study progress and enhance the profile of the CARE study.
Year(s) Of Engagement Activity 2021
URL https://www.ed.ac.uk/usher/edinburgh-clinical-trials/our-studies/all-current-studies/care/care-study
 
Description Presentation delivered by Neil Kitchen about the CARE study and progress to date. 23/9/2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact To update on study progress and enhance the profile of the CARE study.
Year(s) Of Engagement Activity 2021
URL https://www.sbns.org.uk/index.php/conferences/dundee-2021/
 
Description Presentation delivered by Neil Kitchen about the CARE study and progress to date. 9/9/2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact To update on study progress and enhance the profile of the CARE study.
Year(s) Of Engagement Activity 2021
URL https://www.ed.ac.uk/usher/edinburgh-clinical-trials/our-studies/all-current-studies/care/care-study
 
Description Presentation delivered by Rustam Salman entitled - Optimizing the management of Cavernomas at the Royal College of Surgeons Edinburgh. 6 April 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact The management of cavernous malformations can be challenging with many questions for treating clinicians to address. Should incidental lesions be followed up? What risk of bleeding should you inform the patient? When should a brainstem cavernoma be resected - after the first, second bleed, ever? How should you approach a cavenoma surgically? This webinar brings two leaders in the field of cavernoma. Prof Al-Shahi Salman will go through the evidence base and Mr Fouyas will talk about surgical approaches to these fascinating lesions.
Year(s) Of Engagement Activity 2022
URL https://www.ed.ac.uk/usher/edinburgh-clinical-trials/our-studies/all-current-studies/care/care-study
 
Description Presentations to patient organisations 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact Patient education and information

Charitable funding (£20,000) was raised for the patient organisation as a result of my involvement.
Year(s) Of Engagement Activity 2007,2008,2009,2010,2011,2012,2013,2014,2015,2016
 
Description Press release about article in The Lancet Neurology 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact People at risk of a bleed in their brain will be helped by a study that has calculated the likelihood of bleeding occurring.
Year(s) Of Engagement Activity 2015
URL http://www.ed.ac.uk/news/2015/cavernoma-021215
 
Description RCPE neurology symposium 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Organised a one day programme on neurology with guest speakers and a plenary session with well known comedian Francesca Martinez who writes, acts and has cerbral palsy.
Year(s) Of Engagement Activity 2021
URL https://events.rcpe.ac.uk/neurology-1
 
Description RESTART website 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Participants in your research and patient groups
Results and Impact RESTART trial website

Information for the public and patients about this trial
Year(s) Of Engagement Activity 2012,2013
URL http://www.RESTARTtrial.org
 
Description RUSH patient advisory group meeting 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Patients, carers and/or patient groups
Results and Impact Rustam to complete
Year(s) Of Engagement Activity 2020
URL https://www.ed.ac.uk/clinical-brain-sciences/research/rush-research-group-overview
 
Description Research to Understand Stroke due to Haemorrhage (RUSH) Patient Reference Group 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Patients, carers and/or patient groups
Results and Impact Information about my patient reference group, who provide input on all of our research activities
Year(s) Of Engagement Activity 2016,2017,2018
URL http://www.ed.ac.uk/clinical-brain-sciences/research/diagnoses-disease-targets/rush/rush-patient-ref...
 
Description Research to Understand Stroke due to Haemorrhage (RUSH) website 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Website describing the work of my whole programme of research

Information for patients and charitable donations as a result
Year(s) Of Engagement Activity 2012,2013,2014,2015,2016
URL http://www.rush.ed.ac.uk
 
Description Row Fogo centre advisor 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Advisor to University philanthropic centre
Year(s) Of Engagement Activity 2020
URL https://www.ed.ac.uk/clinical-brain-sciences/research/row-fogo-centre
 
Description Selected as paper of the month for the Lancet SoSTART paper by World Stroke Organisation 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact The publication of the SOSTART trial in Lancet Neurology was given 'paper of the month' by the World Stroke Organisation.
Year(s) Of Engagement Activity 2021
URL https://www.world-stroke-academy.org/news/the-paper-of-the-month-october/
 
Description Sentinel Stroke National Audit Programme External Reference Group 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact To ensure that SSNAP remains a leader in quality improvement in stroke care we seek the consultation of an external reference group to review and provide constructive advice and criticism to the programme team to help us deliver our challenging and ambitious agenda. Membership is comprised of opinion leaders both within and outside of the stroke field and bring academic, service, international and patient perspectives.

Representatives invited include: international and national representatives, Royal College of Physicians, NICE, Public Health England.
Year(s) Of Engagement Activity 2021
 
Description Speaker - From Holmes to House - 500 years of the diagnostic neurologist 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact "The risks of over-diagnosis in neurology - a 21st century ill?"
Year(s) Of Engagement Activity 2018
URL https://www.rcplondon.ac.uk/events/holmes-house-500-years-diagnostic-neurologist
 
Description Speaker at BRAINSTORM meeting 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk about trial results to interventional neuroradiologists
Year(s) Of Engagement Activity 2017
 
Description Speaker at Nurses Open Day RIE 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Around 50 nurses and students attended the Nurses and Midwives Research Open Day and the RIE on the 1st Feb 2018. The aim was to promote awareness of nursing research happening in and around Edinburgh. I was invited to speak about the path I had taken into research and details of the study linked to my PhD.
Year(s) Of Engagement Activity 2018
 
Description Speaker at the 39th Edinburgh Clinical Neurology Course 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact "Bleeding in and around the brain"
Year(s) Of Engagement Activity 2017
 
Description Speaker at the Edinburgh Stroke Winter School 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact "Is it worth doing observational research?"
Year(s) Of Engagement Activity 2018
URL https://www.ed.ac.uk/clinical-brain-sciences/postgraduate-training/edinburgh-stroke-winter-school
 
Description Spotlight delivered by Carole Turner about the CARE study and progress to date. Society of British Neurological Surgeons 15 April 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact To update on study progress and enhance the profile of the CARE study.
Year(s) Of Engagement Activity 2021
URL https://www.sbns.org.uk/index.php/conferences/spring-meeting-2021/
 
Description Stroke 2013 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Up-to-date information about managing stroke

Publicisation of best practice in managing brain haemorrhage, and opportunities to do research to improve future care
Year(s) Of Engagement Activity 2013
URL http://www.rcpsg.ac.uk/~/media/Files/Events/Stroke/Stroke_2013_Flyer_Single%20Pages.pdf
 
Description Stroke Research Network: 'Patient, Carer & Public Involvement Day' 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Patients, carers and/or patient groups
Results and Impact The day was targeted at Patients, Carers & Public in and around Glasgow, and was an opportunity for attendees to learn more about stroke research and how they can become involved as a lay person. I had a table at this event where I spoke to attendees about the research that we are doing which sparked questions and discussions relating to some of the long-term impacts of stroke and how these have effected both the patients and their family.
Year(s) Of Engagement Activity 2015
 
Description Talk about observational research vs. randomised trials to future stroke researchers 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Postgraduate students
Results and Impact Talk about observational research vs. randomised trials to future stroke researchers
Year(s) Of Engagement Activity 2020
URL https://www.ed.ac.uk/clinical-brain-sciences/postgraduate-training/eso-edinburgh-stroke-research-wor...
 
Description Talk at Edinburgh Stroke Winter School 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Talk to would-be research fellows on "Intracranial haemorrhage: challenges and answerable questions", to inspire them to seek funding to answer these questions
Year(s) Of Engagement Activity 2017
URL http://www.ed.ac.uk/clinical-brain-sciences/postgraduate-training/edinburgh-stroke-winter-school
 
Description Talk on management of intracranial vascular malformations 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact 40 doctors attended my talk, which influenced their management of patients

I was invited to participate in an American Heart Association guidelines panel
Year(s) Of Engagement Activity 2014
 
Description Talk to Calgary Stroke programme - Oral Anticoagulation for Atrial Fibrillation after a Brain Hemorrhage: New Data, New Challenges 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Oral Anticoagulation for Atrial Fibrillation after a Brain Hemorrhage: New Data, New Challenges
Year(s) Of Engagement Activity 2021
 
Description Talk to Sheffield neuroscience department 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Invited lecture to neuroscience department
Year(s) Of Engagement Activity 2017
 
Description Talk to University Hospital Leuven, Herestraat 49, 3000 Leuven: Can we diagnose cerebral amyloid angiopathy (CAA) without brain magnetic resonance imaging (MRI)? - 26 April 2018 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Invited lecture to academic group in Netherlands
Year(s) Of Engagement Activity 2018
 
Description Talk to the Asia Pacific Stroke Congress December 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact XIth ASIA PACIFIC
STROKE CONGRESS
DEC 9-11, 2021
CHENNAI, INDIA
STROKE CARE IN CHALLENGING TIMES
Year(s) Of Engagement Activity 2021
URL https://apscindia2021.com/pdf/full.pdf
 
Description Talk to the Edinburgh Stroke Winter School 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Talk on the pros and cons of observational research to aspiring academic clinicians.

Two clinical research fellows were recruited to my department.
Year(s) Of Engagement Activity 2014,2015,2016
URL http://www.ed.ac.uk/schools-departments/clinical-brain-sciences/postgraduate-training/edinburgh-stro...
 
Description Talk to the Glasgow Neuro Society on including academia at the arly atage of your medical career 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Undergraduate students
Results and Impact A talk to interested neuro students on the benefits of inclusing academia in their early careers
Year(s) Of Engagement Activity 2021
URL https://www.glasgowneuro.co.uk/
 
Description Talk to the Walton Centre grand round - 'Cracking the cavernoma conundrum: treatment with or without surgery' 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Grand round talk on Cracking the cavernoma conundrum:treatment with or without surgery. To update on study progress and enhance the profile of the CARE study.
Year(s) Of Engagement Activity 2022
URL https://www.ed.ac.uk/usher/edinburgh-clinical-trials/our-studies/all-current-studies/care/care-study
 
Description Teaching session on stroke for undergraduate nurses 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Undergraduate students
Results and Impact Teaching session on stroke and how it may present. Linked into current research activities taking place at Edinburgh.
Year(s) Of Engagement Activity 2018
 
Description Topic group member for the 2022 National Clinical Guideline for Stroke for the UK and Ireland 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Topic group member for the 2022 National Clinical Guideline for Stroke for the UK and Ireland
Year(s) Of Engagement Activity 2021
 
Description UK Biobank stroke outcomes working group 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact To determine how to identify strokes that occur amongst UK Biobank participants

Changed approach to coding stroke in UK Biobank
Year(s) Of Engagement Activity 2012
 
Description UK Health Alliance on climate change Meeting in my role as President on BASP 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Carbon reduction in stroke medicine
Year(s) Of Engagement Activity 2020
URL http://www.ukhealthalliance.org/
 
Description UK Stroke Forum 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Paper Presentation
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Invited talk and ongoing trials stand at the UK Stroke Forum

Increase number of centres in RESTART and ultimately trial recruitment
Year(s) Of Engagement Activity 2012,2013,2014,2015,2016
URL https://www.stroke.org.uk/professionals/uk-stroke-forum/uksf-conference
 
Description UKTMN confrence parallel session - 22 March 2022 talk on Carbon Footprint in Trials 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Rustam gave a talk on simple ways to redue the impact of clinical trials on our carbon footprint.
Year(s) Of Engagement Activity 2022
URL https://www.tmn.ac.uk/events/uktmn-annual-conference-2022
 
Description Update on CARE study progress to CAUK website 30/6/2021 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact A publicity piece about the progress of the the CARE pilot trial was posted by CAUK on their website with the aim of engaging patients with the trial.
Year(s) Of Engagement Activity 2021
URL https://cavernoma.org.uk/care-study/recruitment/
 
Description Vice chair, European Stroke Organisation committee for guidelines on the management of intracerebral haemorrhage 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Vice chair, European Stroke Organisation committee for guidelines on the management of intracerebral haemorrhage
Year(s) Of Engagement Activity 2021
 
Description Virtual Stroke Masterclass: Haemorrhagic stroke- what's new? 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Part of the faculty who delivered 'Virtual Stroke Masterclass' event on 18 February 2021. I gave a talk on 'Haemorrhagic stroke - what's new?'.
Year(s) Of Engagement Activity 2021
 
Description World Stroke Day public engagement information stand in my hospital 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? Yes
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Information stand about my research and information about the condition that it focuses on, for World Stroke Day.

One hundred people had their blood pressure checked and several required treatment with antihypertensive drugs for primary prevention.
Year(s) Of Engagement Activity 2014
 
Description World Stroke Day public lecture 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Public/other audiences
Results and Impact Lecture to the public on World Stroke Day
Year(s) Of Engagement Activity 2015
 
Description World Stroke Day stand 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Public/other audiences
Results and Impact The RUSH team set up a stand in the Edinburgh Royal Infirmary concourse on 27th October, World Stroke Day. We invited colleagues from the NHS,The Stroke Association and
CHSS to provide information about stroke and some of the current research studies that are taking place. Nurses conducted blood pressure checks for patients, staff and visitors, and distributed
information.
Year(s) Of Engagement Activity 2017
 
Description World Stroke Day talk 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Talk about the importance of lowering blood pressure to prevent stroke, as part of the Global Health Academy event on World Stroke Day.
Year(s) Of Engagement Activity 2015
URL http://www.ed.ac.uk/global-health/news-events/events/past-events/global-story-of-strokes
 
Description Written information leaflets for patient support organisations 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Participants in your research and patient groups
Results and Impact The first patient information leaflets for patients in the UK with this condition

Patients better informed. Grants awarded from the patient support organisation to underpin further similar activities
Year(s) Of Engagement Activity 2008,2009,2010,2011,2012,2013,2014