Henry J.M. Barnett Scholarship Award 2007/2008 - Butcher

Dr. Ken Butcher
University of Alberta
When a stroke causes bleeding into the brain, blood pressure is most often very high. Clinicians might respond by either allowing the pressure to remain high or by lowering it quickly. Which strategy is better is the subject of an important debate that Dr. Ken Butcher is attempting to resolve with the use of an innovative technology.
Dr. Butcher, an assistant professor in the University of Alberta’s department of medicine, has been using a high-speed scanning technique known as CT perfusion imaging to better understand this issue. This method, which provides detailed measurements of blood flow in the brain, will be carried out on individuals within a few hours of having suffered a stroke.
Bleeding in the brain in most cases results from high blood pressure, which causes blood vessels to become brittle and eventually burst. Patients with higher blood pressure after stroke don’t recover as well. This might be because high blood pressure makes it difficult for the ruptured vessel to clot and stop the bleeding. The debate stems from the fact that if you attempt to address this with drugs to decrease blood pressure, you run the risk of dropping it too low or too quickly (or both), starving the brain of blood and making things even worse. 
The CT perfusion brain scan offers a high resolution, real-time image that can be used to visualize blood flow. This makes it possible to confirm that the brain is continuing to receive enough blood to avoid further damage.
Dr. Butcher suggests that it is possible and preferable to lower a patient’s blood pressure quickly, without reducing blood flow to the brain and causing further damage. If these pilot studies confirm this approach is safe, Dr. Butcher will carry out a randomized controlled trial to assess whether it can also reduce death and disability among patients.
This exciting work will offer critical new information about a primary treatment for stroke.