Prognosis and management of intracanial vascular malformations and non-traumatic intracerebral haemorrhage in adults

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

Abstract

Haemorrhage into the brain - known as intracerebral haemorrhage, or ‘ICH‘ for short - is a devastating condition, which kills one third of people within one month. For at least one quarter of adults with ICH, no cause is ever found. Of the known causes of ICH, abnormal tangles of blood vessels in the brain - known as intracranical vascular malformations, or IVMs for short - are the single most common cause of stroke due to ICH in young adults. IVMs can also leave young people disabled for life and cause epilepsy. The Scottish Intracranial Vascular Malformation Study (SIVMS) is the only study of every type of IVM based on a whole population, following adults from the time they are diagnosed. It will provide information for people with IVMs about their prognosis and the effects of treatment. It will also calculate the financial impact of IVMs and whether they are associated with conventional risk factors for blood vessel diseases.

Technical Summary

Aims:

1. Resume recruitment and continue fellow-up of a unique prospective, population-based study of intracranial vascular malformations (IVMs), which are the commonest cause of haemorrhagic stroke in young adults, as well as a not uncommom cause of epilepsy: the scottish IVM study (SIVMS)

2. Begin a Lothian-wide study of the incidence, Causes and Haemostatic mechanisms in Primary Intracerebral Haemorrhage (LINCHPIN)

3. Complete my training in neurology and, as a consultant, support a clinical service for adults with IVMs in scotland



Objectives:

1. Systematic reveiws of the prognosis and treatment of IVMs and non-traumatic intracerebral haemorrhage

2. Resume recruitment to SIVMS and continue follow-up of the whole cohort to address aetiology, clinical presentation, prognosis, the effects of treatment, and economic burden

3. Form a network of UK AVM specialists, and create a simple database to use for clinical practice and research

4. Community based Lothian-wide cohort study of ICH (LINCHPIN): contemporary incidence, causes, prognosis for death and recurrent ICH, and whether microhaemorrhages & leukoaraiosis on MRI influence outcome



Design/methods: SIVMS is a prospective epidemiological cohort study, based on the whole adult population of Scotland. the study is built oupon successful, multidisciplinary, all-inclusive collaboration between radiologists, neurologists, stroke physicians, neurosurgeons and pathologists, and is steered by a committee representative of all four clinical features at presentation, and annual prospective follow-up data about a huge variety of outcomes and receipt of treatment (with any of surgical excision, endovascular embolisation, and stereotactic radiosurgery). LINCHPIN will be a prospective, community-based cohort study using similar case ascertainment as well as a hot pursuit model involving early clinical assessment, consent, blood sample collection and MRI brain scanning.



Scientific/Medical opportunities: SIVMS is a unique study, poised to address the long-term prognosis of IVMs. ICH and IVMs are of particular interest now because of their detection is likely to be rising with the widespread availability and uptake of brain imaging. Now is the time to assess the influence on ICH incidence and Prognosis of abnormalities such as microhaemorrhages and leukoaraiosis which are increasingly recognised on MRI, as well as recent strategies for secondary prevention of vascular events, and the decline of routine surgical evaculation of ICH.

Publications

10 25 50
 
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 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 British Neurological Surveillance Unit
Geographic Reach National 
Policy Influence Type Participation in advisory committee
 
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 Clinical Practice Guideline for the Management of Intracranial Aneurysms
Description Citation in clinical practice guideline
Geographic Reach Asia 
Policy Influence Type Citation in clinical guidelines
Impact Avoidance of use of magnesium treatment
URL http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4239410
 
Guideline Title European Stroke Organisation (ESO) guidelines on management of transient ischaemic attack
Description Citation of RESTART trial in European Stroke Organisation (ESO) guidelines on management of transient ischaemioc attack
Geographic Reach Europe 
Policy Influence Type Citation in clinical guidelines
Impact Accurately identifying high risk TIA patients may be helpful in decisions relating to initial triage for assessment and treatment. Early access to imaging and cost of CT and MRI varies across different health systems. Advanced imaging such as MR (multimodal) or CT perfusion can identify acute ischaemic lesions after transient neurological symptoms and thus may accurately confirm ischaemic pathophysiology and help identify ischaemic mechanism. Our analyses of the currently available evidence show that early initiation of DAPT with aspirin and clopidogrel in high risk non-cardioembolic TIA patients for up to 21 days reduces the risk of stroke recurrence over single antiplatelet treatment.
URL https://journals.sagepub.com/doi/full/10.1177/2396987321992905
 
Description Department for Transport DVLA committee
Geographic Reach National 
Policy Influence Type Gave evidence to a government review
Impact My study was asked to provide data to inform the DVLA about their regulations on fitness to drive
 
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 Membership of national health service education committee
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact This group considers the training needs of the next generation of stroke doctors
URL https://www.nes.scot.nhs.uk
 
Description Project cited as an example of best practice in "A Manual for Caldicott Guardians" (Copyright 2017 UK Caldicott Guardian Council)
Geographic Reach National 
Policy Influence Type Citation in other policy documents
Impact SAIVMs was cited by our local Caldicott Guardian as an example of audit and research which is integral to high quality prevention, treatment and care, and which has been done in "the right way."
URL https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/581213/cgmanual.pdf
 
Description RCP London working party on research ethics
Geographic Reach Multiple continents/international 
Policy Influence Type Participation in advisory committee
Impact Clear gudance on research ethics
 
Description Revision of the Adults With Incapacity (Scotland) Act 2000
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Gave evidence to a government review
Impact As a result of the difficulties I experienced with gaining research ethics committee approval for my research with the only research ethics committee allowed to adjudicate it in Scotland, I campaigned for applicants to have the right to appeal. The Government subsequently consulted on this change, and it looks likely to be progressing.
 
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 TMRP/SHC/Low Carbon Clinical Trials
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
 
Description Tailored talks for vascular malformations
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
Impact RASS to add detail
 
Description A digital archive and web-based reviewing system for the imaging of intracranial vascular malformations: a tool to measure observer variation
Amount £41,463 (GBP)
Funding ID CZG/2/265 
Organisation Chief Scientist Office 
Sector Public
Country United Kingdom
Start 01/2006 
End 12/2006
 
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 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 CRASH-2 (Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage) IBS (Intracranial Bleeding Study): the effect of tranexamic acid on intracranial bleeding among CRASH-2 trial participants
Amount £109,325 (GBP)
Funding ID 09/102/01 
Organisation National Institute for Health Research 
Department Health Technology Assessment Programme (HTA)
Sector Public
Country United Kingdom
Start 01/2009 
End 09/2009
 
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 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 senior clinical fellowship: Cerebral amyloid angiopathy and intracerebral haemorrhage: community-based cohort study, biobank, and record linkage
Amount £2,105,368 (GBP)
Funding ID G1002605 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 07/2011 
End 07/2016
 
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 Microbleeds and genetic risk factors to predict the risk of intracranial haemorrhage in patients treated with anticoagulation following cardioembolic stroke due to AF
Amount £939,718 (GBP)
Funding ID TSA/BHF 2009/01 
Organisation British Heart Foundation (BHF) 
Sector Charity/Non Profit
Country United Kingdom
Start 05/2011 
End 05/2016
 
Description PATCH (Platelet Transfusion in Cerebral Haemorrhage)
Amount £86,985 (GBP)
Funding ID Res10 
Organisation Chest Heart & Stroke Scotland 
Sector Charity/Non Profit
Country United Kingdom
Start 01/2010 
End 01/2016
 
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 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 The genetic factors predisposing to brain arteriovenous malformations (BAVMs), and their effect on BAVM presentation, prognosis and response to treatment
Amount £93,000 (GBP)
Funding ID TSA/2006/13 
Organisation Stroke Association 
Sector Charity/Non Profit
Country United Kingdom
Start 01/2006 
End 12/2007
 
Description Validation and phenotyping of stroke outcomes in UK Biobank
Amount £167,655 (GBP)
Organisation UK Biobank 
Sector Charity/Non Profit
Country United Kingdom
Start 12/2011 
End 12/2013
 
Title Biobank of adults with intracranial vascular malformations 
Description Clinical, radiological, and DNA repository from adults with intracranial vascular malformations 
Type Of Material Biological samples 
Year Produced 2007 
Provided To Others? Yes  
Impact Multiple publications 
 
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 Web-based imaging review system 
Description Web-based system for review and data collection from a variety of neuroradiological imaging techniques 
Type Of Material Improvements to research infrastructure 
Provided To Others? No  
Impact Data collection to validate patients included in a population-based disease register, and collect data for a study on inter-rater reliability 
 
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 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 LSHTM 
Organisation London School of Hygiene and Tropical Medicine (LSHTM)
Department Faculty of Epidemiology and Population Health
Country United Kingdom 
Sector Academic/University 
PI Contribution Design of a sub-study, successful application for HTA funding, and analysis
Collaborator Contribution Sub-study of a large, international randomised controlled trial
Impact Paper published in BMJ. Springboard to further grant application, in collaboration with University of Nottingham
Start Year 2008
 
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 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 Microbleed Study Group 
Organisation National Center for Biotechnology Information (NCBI)
Country United States 
Sector Public 
PI Contribution Contribution to writing a manuscript
Collaborator Contribution Culminated in publication
Impact Publication of review in Lancet Neurology, Pub Med ID 19161908
Start Year 2007
 
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 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 NIHR PI associate scheme and BASP 
Organisation National Institute for Health Research
Country United Kingdom 
Sector Public 
PI Contribution rustam to add details
Collaborator Contribution Rustam to add details
Impact This is a scheme to encourage young stroke trainees to the specialty.
Start Year 2021
 
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 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 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
 
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 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 42nd Edinburgh Clinical Neurology Course presentation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation to neurologist from across Scotland
Year(s) Of Engagement Activity 2021
URL https://www.ed.ac.uk/clinical-brain-sciences/postgraduate-study/edinburgh-clinical-neurology-course
 
Description 7th Annual Trials Methodology Symposium Ireland 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Gave talk on low carbon trials
Year(s) Of Engagement Activity 2021
URL https://www.hrb-tmrn.ie/training-education/7th-trials-methodology-symposium/?mc_cid=1df937c08d&mc_ei...
 
Description AGP Alliance representing 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 Rustam to complete
Year(s) Of Engagement Activity 2020
URL https://www.basp.org/wp-content/uploads/2020/11/AGP-Alliance-position-paper-27-October-2020.pdf
 
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 BASP Trainees weekend March 2021 
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 Over 200 interested trainees attended a 2 day on line event focussing on training for stroke physicians
Year(s) Of Engagement Activity 2021
URL https://fitwise.eventsair.com/basp-trainees-teaching/
 
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 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 Clinical Trial Organisation 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 Purpose
Ongoing oversight of the clinical trial pathway and completion of recommendations of external review. The aim is to ensure academic and financial success of the clinical trials pipeline. This will involve:
• Prioritising needs
• Horizon scanning upcoming major funding calls
• Understanding and solving process-related bottlenecks
• Triaging work where specific areas are under pressure from workload
• Allocation of NHS and University resource, which can be reported back to the Joint Oversight Board.
Year(s) Of Engagement Activity 2021
 
Description Clinical research fellow shortlisted for Max Perutz writing award 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? Yes
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact The clinical research fellow who I mentored and supervise on an MRC clinical research training fellowship was shortlisted for the MRC's Max Perutz writing award

Piece disseminated to participants in our research
Year(s) Of Engagement Activity 2011
 
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 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 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 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 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 Event for participants in SAIVMs 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Participants in your research and patient groups
Results and Impact Whole day event for patients participating in my population-based study, involving patient support organisations

Further fundraising activities
Year(s) Of Engagement Activity 2010
 
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 Gave talk to the Brain /school event run by UCL London 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Delivered an online talk on the CARE trial
Year(s) Of Engagement Activity 2021
URL http://www.brainschool.co.uk/the-brain-school-team.html
 
Description How to be a good chief investigator 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact How to be a good chief investigator
Year(s) Of Engagement Activity 2019
 
Description How to be a good clinical trial Chief Investigator - a talk to the NRS Fellows/NRS Clinicians Meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact NRS Fellows/NRS Clinicians Meeting. Talk given to highlight the ways in which fellow professional could expand their knowledge and work in research and how to be an effective chief investigator. hopefully to encourage others to delve into working in medical research and academia.
Year(s) Of Engagement Activity 2021
 
Description Knowledge sharing webinar on the management of VAT 
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 Expert panel discussing the VATT risks with the covid vaccine rollout.
Year(s) Of Engagement Activity 2021
 
Description Lothian Covid-19 Research Oversight Committee 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact This group meets to discuss research proposals submitted to NHS lothian for Covid-19 and other conditions.
Year(s) Of Engagement Activity 2020,2021
URL https://org.nhslothian.scot/LothianNHSBoard/BoardPapers/BoardPapers/Lothian%20Remobilisation%20-%20A...
 
Description Media article on RESTART presentation at ESOC 2021 
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 Antiplatelet therapy after intracerebral haemorrhage: results from the RESTART trial


Heather Mason Univadis Medical News 10 Sep 2021




>









According to the follow-up results of the RESTART trial published in JAMA Neurology, antiplatelet therapy appears to be safe in patients who have suffered an intracerebral haemorrhage (ICH) and have previously taken antithrombotic therapy.

The analysis included a total of 537 patients who had taken antithrombotic therapy to prevent occlusive vascular disease when they developed ICH, discontinued their antithrombotic therapy, and survived for 24 hours. Participants were followed up for recurrent symptomatic ICH and all major vascular events for up to seven years (median 3 years).

Patients were randomly assigned to start (n=268) or avoid (n=269) antiplatelet therapy. The primary outcome of recurrent ICH affected 22 patients allocated to antiplatelet therapy (8.2%) and 25 of those asked to avoid such therapy (9.3%). The secondary outcome of major vascular events occurred in 26.8 per cent of patients allocated to antiplatelet therapy and 32.5 per cent of those avoiding it.

These findings provide reassurance in the use of long-term antiplatelet therapy after ICH associated with antithrombotic therapy. Despite the recommendation in stroke guidelines reporting that resuming antiplatelet therapy is reasonable, patients and guidelines will need more evidence before clinical practice is effectively changed.
Year(s) Of Engagement Activity 2021
URL https://www.univadis.co.uk/viewarticle/antiplatelet-therapy-after-intracerebral-haemorrhage-results-...
 
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 Medical Research Symposium for students and foundation doctors 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Medical research symposium for students and foundation doctors
Year(s) Of Engagement Activity 2019
 
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 Optimising resource use in outcome collection - the ORINOCO project 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Trials are one of the best ways of testing treatments but they can be expensive and time consuming. The amount of data collected has a big influence on both cost and time.
We aim to understand how much time trial teams spend collecting the most important trial data (called primary outcomes) compared to the other data they collect (secondary outcomes). We also want to understand the time taken to collect core outcome sets-an agreed minimum amount of information-compared with trials that do not use them to see if they improve efficiency, or worsen it.
Year(s) Of Engagement Activity 2021
URL https://www.abdn.ac.uk/hsru/what-we-do/research/projects/orinoco-826.php
 
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 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 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 Presentation to Kings College Hospital London on 'Cracking the Cavernoma Conundrum' 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Professional Practitioners
Results and Impact Rustam to complete
Year(s) Of Engagement Activity 2020
 
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 Presented award at UK Stroke Forum 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact In my capacity as president of the British Association of Stroke Physicians, I presented the BASP President's Award to Deb Lowe, National Clinical Director for Stroke, NHS England.
Year(s) Of Engagement Activity 2021
URL https://www.stroke.org.uk/professionals/uk-stroke-forum
 
Description Promotional video to highight the results of the RESTART TRIAL 
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 Professional Practitioners
Results and Impact Promotional video explaining the results of the RESTART Trial which stopped recruiting in July 2021. The video explains the results in simple terms providing accessibility to all viewers.
Year(s) Of Engagement Activity 2021
URL http://www.restarttrial.org/default.html
 
Description RCP MED+ conference 2021 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Gave talk on 'Intraceberal haemorrhage' on 26 October 2021
Year(s) Of Engagement Activity 2021
URL https://rcpconferences.co.uk/med-plus/login
 
Description RCP Med+ Conference 
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 Organised the RCP annaul MED+ conference.
Year(s) Of Engagement Activity 2021
URL https://rcpconferences.co.uk/med-plus/login
 
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 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 SAIVMs open day 
Form Of Engagement Activity Participation in an open day or visit at my research institution
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Participants in your research and patient groups
Results and Impact 150 study participants attended an open day to hear the results of the research and meet patient support groups

None
Year(s) Of Engagement Activity 2010
 
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 Session organiser and speaker for the British Cardiovascular Society Annual Conference, Manchester 
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 "Dilemmas in investigation and management of embolic stroke"
Year(s) Of Engagement Activity 2017
 
Description Some surprising recent findings about 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 Keynote speech to the Catalan Scoeity of Neurology at the on-line virtual conference from 3-7 May 2021.
Year(s) Of Engagement Activity 2021
URL https://www.scneurologia.cat/reunio-anual-de-la-societat-catalana-de-neurologia/
 
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 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 Strategic interest group 6: Sustainability in academia/research/clinical trials 
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 on academia and sustainability in clinical trials.
Year(s) Of Engagement Activity 2021
 
Description Stroke 5-nations Covid 19 meetings 
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 5 nation meeting every week to discuss the impact of Covid 19 on the stroke service nationally across the UK.
Year(s) Of Engagement Activity 2020
 
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 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 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 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 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 Neurovascular group 
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 Presentation of the breaking results of the ARUBA randomised controlled trial.

Practice-changing implications of the results
Year(s) Of Engagement Activity 2013
URL http://www.arubastudy.org
 
Description UK Stroke Forum 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact What's hot and what's next? RESTART
Year(s) Of Engagement Activity 2019
 
Description UK Stroke Forum 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact A rush of blood to the head: update on acute intracerebral haemorrhage in 2019
Stop the clots: State of the art in vascular secondary prevention after intracerebral haemorrhage
Year(s) Of Engagement Activity 2019
 
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 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