Cognitive, auditory and other health outcomes after subarachnoid haemorrhage, and genetic determinants

Subarachnoid haemorrhage is a common cause of stroke in young and middle-aged adults caused by a bleed on the brain. It occurs after rupture of a swelling (or aneurysm) on a major artery supplying the brain and results in release of blood over the brain surface (or the subarachnoid space), which then clots. In survivors, subarachnoid haemorrhage results in substantial loss of quality of life, and a significant cost to the UK economy due to inability to return to work. There is increasing recognition that, although people with a history of SAH look outwardly healthy, they have substantial “hidden” disability which impairs their daily functioning. These hidden deficits mostly consist of problems with memory, concentration and processing of heard information such as speech and music. There are no treatments to prevent or improve recovery from these deficits. Hence a better understanding as to what contributes to a poor outcome after brain haemorrhage is needed. There are over a thousand UK BioBank participants with a history of subarachnoid haemorrhage. First we intend to confirm that employment, physical activity, memory and concentration and hearing is reduced in people with a history of subarachnoid haemorrhage compared to people who have not had a subarachnoid haemorrhage. Then we intend to see whether any specific variation in the genetic code of individuals with a history of subarachnoid haemorrhage predisposed them to a worse or better outcome. It is possible that certain genetic variations may reflect a biological process which can be improved or inhibited with available drugs. We hope that this study will demonstrate the importance of the hidden deficits after subarachnoid haemorrhage, identify potential new treatments and ultimately help improve the management of people with subarachnoid haemorrhage. Finally this study will provide two students, working under our close supervision, with experience in research.