We'd like your feedback
Your feedback is important to us. It will help us improve the quality of the study information on this site. Please answer both questions.
Contact the study team using the details below to take part. If there are no contact details below please ask your doctor in the first instance.
Mr
Cameron
Skinner
cameron.skinner@nottingham.ac.uk
Prof
Nikola
Sprigg
nikola.sprigg@nottingham.ac.uk
More information about this study, what is involved and how to take part can be found on the study website.
Hyperacute primary intracerebral haemorrhage (stroke)
This information is provided directly by researchers, and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information. In some summaries, you may come across links to external websites. These websites will have more information to help you better understand the study.
Tranexamic acid is a standard treatment in bleeding emergencies such as trauma and childbirth, where it reduces deaths from bleeding. A recent study showed that tranexamic acid given within 8 hours of a bleed on the brain is safe and prevents hematoma (abnormal collection of blood) growth. There was also a small reduction in the number of patients who died within the first 7 days. The study was not large enough to show whether there were effects on long-term disability. Tranexamic acid is cheap (£12) and easy to administer. If it is effective it could make a difference to patients with a bleed on the brain and their families worldwide.
The researchers have worked closely with stroke survivors and their carers to design this study. They told them that increased survival is important, but most people would not want to be alive at the expense of very severe disability, and also that 3 months is too early to measure recovery after stroke 6 months is more appropriate. The researchers discussed emergency consent in detail, and their advisors suggested that most people would be happy with the emergency consent procedure for this study. They also would prefer a blinded study where participants do not know which treatment they receive.
Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.
The recruitment start and end dates are as follows:
You can take part if:
You may not be able to take part if:
Current key exclusion criteria as of 23/02/2026:
TICH-3 comparison:1. Patient with a known indication for TXA treatment (e.g. traumatic brain injury)2. Patient with contraindication for TXA treatment3. Patient known to be taking therapeutic anticoagulation with warfarin or low molecular weight heparin at the time of enrolment. Patients taking direct oral anticoagulants can be included and are not excluded.4. Massive ICH for which haemostatic treatment seems futile (This would ordinarily be when haematoma volume is estimated as larger than 60ml)5. Severe coma (Glasgow Coma Scale <5)6. Decision was already taken for palliative (end of life) care with the withdrawal of active treatment
DASH-2 comparison:1. Massive ICH for which haemostatic treatment seems futile (This would ordinarily be when haematoma volume is estimated as larger than 60ml (+/-10%))2. Aneurysmal subarachnoid haemorrhage3. Haemorrhage known to be due to transformation of infarction4. Haemorrhage known to be due to a thrombolytic drug,5. Haemorrhage known to be due to venous thrombosis,6. Risk/s of fluid retention associated with desmopressin judged clinically significant by the attending physician (for example patients with pulmonary oedema and/or cardiac failure),7. Significant hypotension (systolic blood pressure <90mmHg),8. Known drug-eluting coronary artery stent in previous three months,9. Known unstable angina or acute coronary syndrome in past month,10. Known allergy to desmopressin,11. Pregnant or breast-feeding,12. Life expectancy less than four hours, or planned for palliative care only13. Glasgow coma scale less than 5.14. Use of substances that are known to induce syndrome of inappropriate ADH section (SIADH), for example, tricyclic antidepressants, selective serotonin re-uptake inhibitors, chlorpromazine and carbamazepine, may cause an additive antidiuretic effect leading to increased rick of water retention and/or hyponatremia.
_____
Previous participant exclusion criteria as of 01/03/2023:
1. Patient with a known indication for TXA treatment (e.g. traumatic brain injury)2. Patient with contraindication for TXA treatment3. Patient known to be taking therapeutic anticoagulation with warfarin or low molecular weight heparin at the time of enrolment. Patients taking direct oral anticoagulants can be included and are not excluded.4. Massive ICH for which haemostatic treatment seems futile (This would ordinarily be when haematoma volume is estimated as larger than 60ml)5. Severe coma (Glasgow Coma Scale <5)6. Decision was already taken for palliative (end of life) care with the withdrawal of active treatment
_____
Previous participant exclusion criteria:
1. Indication for TXA2. Patient known to be taking anti-coagulation3. Glasgow Coma Scale (GCS) <54. Estimated haematoma volume (HV) >60 ml5. Palliative care
Below are the locations for where you can take part in the trial. Please note that not all sites may be open.
Mr
Cameron
Skinner
cameron.skinner@nottingham.ac.uk
Prof
Nikola
Sprigg
nikola.sprigg@nottingham.ac.uk
More information about this study, what is involved and how to take part can be found on the study website.
The study is sponsored by University of Nottingham and funded by National Institute for Health Research; Programme Hospitalier de Recherche Clinique.
Your feedback is important to us. It will help us improve the quality of the study information on this site. Please answer both questions.
You can print or share the study information with your GP/healthcare provider or contact the research team directly.
