Condition category
Circulatory System
Date applied
Date assigned
Last edited
Retrospectively registered
Overall trial status
Recruitment status

Plain English Summary

Background and study aims
We are interested in developing a new treatment for patients with a stroke caused by bleeding into the brain (intracerebral haemorrhage). In the hours to days after bleeding occurs, we know that inflammation occurs in the brain around the blood clot. Although inflammation is the body's natural response to injury, when it continues unchecked it can worsen damage. We know that it does worsen damage after an intracerebral haemorrhage and we want to investigate whether blocking inflammation can improve outcomes. Between the blood and brain, there is a blood-brain barrier. How much of a drug can get to where it needs to act in the brain is largely governed by how well it can cross the blood-brain barrier. This makes the blood-brain barrier very important in drug development, as drugs to block brain inflammation have to cross it to get to where they need to go. However, when the brain is damaged, the blood-­brain barrier can become leaky. We know very little about this after intracerebral haemorrhage. This study will determine how leaky the blood­-brain barrier is in the first three days after intracerebral haemorrhage.

Who can participate?
Adult intracerebral haemorrhage patients.

What does the study involve?
Participants undergo an MRI scan to measure leakiness in the first 3 days after their stroke. Twenty of these patients will go on to have a PET scan to show brain inflammation 2- 7 days after their stroke. By putting the two scans together, we will be able to estimate how much of an anti-inflammatory drug will get to inflamed areas in the brain. This will help us to know how much of the drug to give and when to give it in subsequent studies.

What are the possible benefits and risks of participating?
There are no benefits to participation in the study but this will be made clear to participants at first approach. Participants will be exposed to ionising radiation during the PET scan. The maximum dose that is received as part of the scan is equivalent to 1.4 years of background radiation in the UK. There may also be discomfort associated with the blood sampling and MRI/PET scan.

Where is the study run from?
Salford Royal NHS Foundation Trust (UK).

When is the study starting and how long is it expected to run for?
October 2015 to August 2017.

Who is funding the study?
National Institute for Health Research (UK).

Who is the main contact?
Sharon Hulme

Trial website

Contact information



Primary contact

Mrs Sharon Hulme


Contact details

Clinical Sciences Building
Salford Royal NHS Foundation Trust
Stott Lane
M6 8HD
United Kingdom



Additional contact

Dr Adrian Parry-Jones


Contact details

Clinical Sciences Building
Salford Royal NHS Foundation Trust
Stott Lane
M6 8HD
United Kingdom

Additional identifiers

EudraCT number number

Protocol/serial number


Study information

Scientific title

IntraCerebral Haemorrhage: Imaging Microglial Activation and blood­brain barrier leakaGE (IMAGE-ICH) - an observational cohort study



Study hypothesis

Observational study to determine the extent to which blood-brain barrier breakdown during acute ICH co-localises with activated microglia.

More details can be found here:

Ethics approval

NRES Northwest-Haydock committee, 20/10/2015, ref: 15/NW/0677

Study design

Non-randomised; Observational; Design type: Cohort study

Primary study design


Secondary study design

Cohort study

Trial setting


Trial type


Patient information sheet

Not available in web format, please use the contact details below to request a patient information sheet


Topic: Stroke; Subtopic: Acute Care; Disease: In hospital study, Community study


This is an observational study, thus no intervention is being tested. Baseline assessment will include demographics, premorbid health and medications, details of presenting signs and symptoms, clinical observations, National Institutes of Health Stroke Scale (NIHSS), and details of clinical management. A research MR scan will be performed within 3 days of onset, at SRFT. If additional inclusion criteria are met, participants will undergo a [11C](R)-PK11195 PET scan at 2-7 days after symptom onset. Blood samples will be collected for CRP, IL-6, ESR and FBC at each scanning session. A 90-day assessment will measure clinical outcomes and complete participation.

Intervention type



Drug names

Primary outcome measures

To determine the extent to which blood-brain barrier breakdown during acute ICH co-localises with activated microglia

Secondary outcome measures

1. To determine whether the magnitude and extent of blood-brain barrier breakdown is associated with haematoma size and location after ICH
2. Perform exploratory analyses testing for associations between blood-brain barrier permeability and brain inflammation with peripheral inflammatory markers and clinical outcomes

Overall trial start date


Overall trial end date


Reason abandoned


Participant inclusion criteria

1. Age 18 or over
2. Acute, spontaneous, supratentorial ICH within 24 h of symptom onset
3. Glasgow coma scale (GCS) score = 9
4. Research MR scan can be performed within 3 days of symptom onset.

Additional inclusion criteria for PET imaging (d 2­7):
5. GCS = 14
6. Able to transfer from chair to bed with assistance of two people
7. Deemed medically stable by medically­ qualified researcher for transfer to Wolfson Molecular Imaging Centre (WMIC) on day of PET scan

Participant type


Age group




Target number of participants

Planned Sample Size: 40; UK Sample Size: 40

Participant exclusion criteria

1. Contraindication to magnetic resonance (MR) scanning
2. Pre-existing ­brain lesion (e.g. tumour, previous stroke) that is likely to interfere with the planned analysis
3. ICH known or strongly suspected of being secondary to a structural vascular malformation (e.g. cerebral aneurysm, arteriovenous malformation, cavernoma, dural arteriovenous fistula), tumour, haemorrhagic transformation of an ischaemic stroke, or venous sinus thrombosis.
4. Clear history of recent (<7 days prior to onset) head trauma, thought to be the cause of intracerebral haemorrhage.
5. Any known inflammatory disease which in the opinion of the PI may interfere with interpretation of the study results.
6. Known, uncorrected bleeding disorder.
7. Female patient who may be pregnant or who is breast feeding
8. Significant renal impairment (estimated glomerular filtration rate < 30)
9. Any other significant disease or disorder which, in the opinion of the PI or his delegatee, may put the participant at risk
because of participation in the study, or may influence the result of the study, or the participant’s ability to participate in the study.
10. Neurosurgical procedure performed since admission or booked for surgery.
11. Treatment with drugs known to or likely to interfere with PK11195 binding (including benzodiazepines, steroids, minocycline) that cannot be stopped
in sufficient time to prevent interference with PET scanning.

Recruitment start date


Recruitment end date



Countries of recruitment

United Kingdom

Trial participating centre

Salford Royal NHS Foundation Trust
M6 8HD
United Kingdom

Sponsor information


University of Manchester (UK)

Sponsor details

Institute of Cardiovascular Sciences
Zochonis Building
Brunswick Street
Oxford Road
M13 9PL
United Kingdom

Sponsor type




Funder type


Funder name

National Institute for Health Research

Alternative name(s)


Funding Body Type

government organisation

Funding Body Subtype

Federal/National Government


United Kingdom

Results and Publications

Publication and dissemination plan

To be confirmed at a later date

Intention to publish date

Participant level data

Available on request

Results - basic reporting

Publication summary

Publication citations

Additional files

Editorial Notes

24/03/2016: Ethics approval information added.