Treatment of Edema Associated With Intracerebral Hemorrhage

Leasure, Audrey C; Kimberly, W. Taylor; Sansing, Lauren H; Kahle, Kristopher T.; Kronenberg, Golo; Kunte, Hagen; Simard, J. Marc; Sheth, Kevin N

doi:10.1007/s11940-015-0392-z

Cited by 22 publications

(11 citation statements)

References 73 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…PHHD has been the target of different treatments for ICH. 15,16 Corticosteroids could be effective in late phases in which vasogenic edema may predominate, however, they have not shown utility and cause a greater number of complications. 37 Similarly, hypertonic solutions did not affect the outcome at 3 months.…”

Section: Discussionmentioning

confidence: 99%

“…However, this kind of treatment is not recommended for patients with ICH due to the high morbidity and mortality, and more clinical trials are needed to verify its efficacy and safety. [14][15][16][17] We analyzed the association between the clinical outcome at 3 months and the decrease in body temperature in the first 24 hours in patients with ICH. Then, we analyzed the association between the PHHD and the decrease in temperature, and finally tested the hypothesis of treating patients with ICH with antihyperthermic drugs for reducing PHHD and improving the clinical outcome.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Antihyperthermic treatment decreases perihematomal hypodensity

et al. 2020

View full text Add to dashboard Cite

ObjectiveTo investigate the effect on perihematomal hypodensity and outcome of a decrease in body temperature in the first 24 hours in patients with intracerebral hemorrhage (ICH). MethodsIn this retrospective study on a prospectively registered database, among the 1,100 patients, 795 met all the inclusion criteria. Temperature variations in the first 24 hours and perihematomal hypodensity (PHHD) were recorded. Patients ≥37.5°C were treated with antihyperthermic drugs for at least 48 hours. The main objective was to determine the association among temperature variation, PHHD, and outcome at 3 months. ResultsThe decrease in temperature in the first 24 hours increased the possibility of good outcome 11-fold. Temperature decrease, lower PHHD volume, and a good outcome were observed in 31.8% of the patients who received antihyperthermic treatment. ConclusionThe administration of early antihyperthermic treatment in patients with spontaneous ICH with a basal axillary temperature ≥37.5°C resulted in good outcome in a third of the treated patients.Glossary ANOVA = analysis of variance; CI = confidence interval; ICH = intracerebral hemorrhage; mRS = modified Rankin Scale; NIHSS = NIH Stroke Scale; OR = odds ratio; PHHD = perihematomal hypodensity.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Antihyperthermic treatment decreases perihematomal hypodensity

et al. 2020

View full text Add to dashboard Cite

show abstract

“…It is reported that statin use prior to ICH is related to decreased PHE (24). As more and more studies suggest PHE may be associated with outcome in ICH, new methods are developed to reduce PHE (16,48). However, although several studies suggest PHE is a prognostic factor for ICH, some other studies have different results.…”

Section: █ Discussionmentioning

confidence: 99%

Prognostic role of perihematomal edema in intracerebral hemorrhage: a systematic review

Ma²,

Zheng³

et al. 2017

Turkish Neurosurgery

View full text Add to dashboard Cite

Although several studies have suggested perihematomal edema(PHE) is associated with prognosis in intracerebral hemorrhage(ICH), the results are different in other studies. The purpose of this study to evaluate the prognostic role of PHE in ICH. According to PRISMA guidelines, a systematic literature search of PubMed, EMBASE, SCOPUS, Web of Science and Cochrane Library was performed. Published clinical studies reporting association between PHE and prognosis in ICH were included. Data were extracted including sample size, patient characteristics, PHE measures, outcome measures and follow-up. A total of 21 studies were included with 6 prospective studies and 15 retrospective studies. PHE measures included perihamatomal edema absolute volume (PHEAV), relative prihematomal edema volume (rPHE), perihematomal edema absolute volume growth (PHEAV growth), perihematomal edema expansion rate(PHEER), relative prihematomal edema growth (relative PHE growth), cytotoxic edema(CE) and perihamatomal edema absolute area (PHEAA). The association of PHEAV/ rPHE /PHEAV growth and outcome are conflicting in different studies. Meta-analysis showed 72h PHEER at 72 hours was significantly associated with poor clinical outcome at 90 days (OR=1.54, 95%CI 1.04-2.22, P 0.001). This study suggests the measures and time points for PHE and outcome are various in previous studies. The prognostic values of PHEAV, rPHE, PHEAV growth and other measures are still controversial. PHEER is likely a prognostic predictor for ICH. Further studies with larger sample size, more accurate measures and more time points are needed to investigate the prognostic role of PHE in ICH and the optimal PHE measure to predict outcome in ICH.

show abstract

“…As these secondary injury pathways can evolve over hours to days, they represent attractive targets for medical intervention. Importantly, it remains largely unknown why patients with similar initial injuries develop variable degrees of PHE expansion, which has been associated with poorer functional outcomes 7, 8. The discovery of novel biomarkers to help identify those patients predisposed to greater secondary injury and PHE expansion is a key step in potentially modifying functional outcome after ICH 9…”

Section: Introductionmentioning

confidence: 99%

Soluble CD163 in intracerebral hemorrhage: biomarker for perihematomal edema

Roy-O’Reilly

Zhu

Atadja

et al. 2017

Ann Clin Transl Neurol

View full text Add to dashboard Cite

ObjectivePatients with intracerebral hemorrhage (ICH) may elaborate varying degrees of perihematomal edema (PHE), requiring closer monitoring and a higher intensity of treatment. Here, we explore whether the soluble form of CD163, a scavenger receptor responsible for hemoglobin sequestration, can serve as a prognostic biomarker of PHE development and poor outcome after ICH.MethodsOur study cohort was comprised of 51 primary age‐ and sex‐matched ICH patients with moderate‐sized, hypertensive deep hemorrhages. Patients were part of a prospective ICH registry cataloguing admission data along with functional outcomes. We measured sCD163 levels in serial serum and cerebrospinal fluid (CSF) samples obtained at prespecified timepoints. Descriptive statistics, including a generalized estimating equation for longitudinal data, were used to analyze sCD163 in relation to ICH outcomes.ResultsAcute serum sCD163 (<48 h postictus) was significantly elevated in ICH patients compared to both acute neurological event controls (P = <0.001) and healthy controls (P = 0.003). As predicted, acute serum sCD163 levels were significantly associated with both hematoma volume expansion (P = 0.009) and PHE expansion (P = 0.002). Further examination determined that patients with high PHE expansion had poorer modified Rankin Scale scores at discharge (P = 0.024), and circulating sCD163 levels were found to be significantly lower in patients with high‐level PHE expansion.InterpretationAcute sCD163 levels may be a useful biomarker for the acute identification of patients at risk for hematoma expansion, perihematomal edema expansion and poorer short‐term outcomes.

show abstract

Treatment of Edema Associated With Intracerebral Hemorrhage

Cited by 22 publications

References 73 publications

Antihyperthermic treatment decreases perihematomal hypodensity

Antihyperthermic treatment decreases perihematomal hypodensity

Prognostic role of perihematomal edema in intracerebral hemorrhage: a systematic review

Soluble CD163 in intracerebral hemorrhage: biomarker for perihematomal edema

Contact Info

Product

Resources

About