About

The Cerebrovascular Research group (CVRG) reflects the diversity of the clinical manifestations of vascular disease in the brain, which are reflected by the depth and breadth of the interests, skills, and outputs of the researchers in the CVRG.

Stroke results from problems with blood vessels in the brain, either when they are blocked (ischaemic stroke) or they burst (haemorrhagic stroke). It affects more than 113,000 people per year in the UK, where there are more than one million stroke survivors. Globally, stroke is the second-leading cause of death and the third-leading cause of death and disability combined.

We conduct research into Ischaemic stroke (due to blockage of a blood vessel), haemorrhagic stroke (due to bleeding from a blood vessel), and transient ischaemic attack (sometimes called a mini-stroke, when a blockage occurs, but quickly clears, so that symptoms are transient). There is a growing recognition that cerebrovascular diseases are also a common cause of dementia, mood disturbance, and other hitherto unrecognised symptoms.

Stroke research in Edinburgh is world leading; our clinical researchers are experts in the design and delivery of multicentre clinical trials and brain imaging. Many of our research studies have affected treatment guidelines in clinical practice, which benefit patients, including:

• The ‘clot busting’ drug alteplase improves ischaemic stroke outcome in all age groups if delivered within 4.5 hours of stroke onset
• Intermittent pneumatic leg compression after stroke prevents deep vein thrombosis and reduces the risk of death
• Antiplatelet therapy seems safe and may be beneficial for secondary prevention after one type of haemorrhagic stroke
• Early tube feeding may substantially reduce the risk of dying after stroke, and that better functional outcomes arise from feeding via nasogastric tube than a PEG tube
• Computerised tomography (CT) scanning is the most cost-effective imaging technique for preventing secondary stroke after a TIA or minor stroke
• Fluoxetine does not seem to improve recovery after stroke
• No difference in the outcome of general versus local anaesthesia for carotid surgery

Our focus is not just on the stroke but also on how the brain vascular system functions and how perturbations to this can affect brain activity and health.  Stroke and underlying conditions such as cerebral small vessel disease can lead to diverse problems with life after stroke including cognition, mood, continence and other symptoms.  Since brain injury (such has head trauma and stroke) is associated with an increased risk of dementia, there is strong integration between our researchers working on stroke and the dementias. Indeed, the disruption of the brain cerebrovascular system, and the interaction between glia, brain-vascular cells and neurons, is the primary focus of our UK Dementia Research Institute at Edinburgh.

We also take a macro view. Our preclinical researchers are exploring the mechanisms underlying neuroimmune signalling, trying to understand why conditions such as pneumonia are common after a stroke. Our clinical researchers are exploring the treatment of patients with haemorrhagic stroke, who are at high risk of all major vascular events, especially those in atrial fibrillation. Others are interested in the social determinants of stroke and the interplay with mental illness.

Finally, we have extensive global collaborations, supporting the conduct of our own research and synthesis of the best available evidence in randomised controlled trials and animal research. Our in-house research nurses also recruit patients in our clinical service to a diverse portfolio of multicentre clinical research studies run by our collaborators.

• Cochrane Stroke Group
• Row Fogo Centre
• Fondation Leduq 
• Research to understand stroke due to Haemorrhage (RUSH)
• Edinburgh Brain and Tissue Bank
• Edinburgh Clinical Trials Unit
• BHF Data Science Centre
• Clinical research and trials in the Centre for Clinical Brain Sciences
• CAMARADES
• Edinburgh Imaging Academy