Surgical treatment of spontaneous intracranial hemorrhage in patients with cancer: Analysis of prognostic factors

Yamaki, Vítor Nagai; Telles, João Paulo Mota; Paiva, Wellingson Silva; Teixeira, Manoel Jacobsen; Neville, Iuri Santana

doi:10.1016/j.jocn.2020.11.002

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…Previous studies showed that excellent medical treatment, including management of blood glucose and pressure, remove of hematoma timely and control of intracranial pressure, can likely improve the outcome of ICH [1,7,8,15,20]. In the present surgical treatment of ICH, with the advantages of minimally invasive and exact therapeutic effect, rapid clearance of hematoma and improving the microcirculation of brain tissue are the main principles [2,[18][19][20]. However, there is still no uni ed conclusion on the timing of operation.…”

Section: Introductionmentioning

confidence: 99%

Predictive Nomogram for Unfavorable Outcome of Spontaneous Intracerebral Hemorrhage

et al. 2022

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Section: Introductionmentioning

confidence: 99%

Predictive Nomogram for Unfavorable Outcome of Spontaneous Intracerebral Hemorrhage

et al. 2022

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“…28 In addition, coagulation dysfunction is an independent risk factor for mortality after surgical treatment in patients with cancer complicated with intracerebral hemorrhage, suggesting that coagulation dysfunction is closely related to the prognosis of cancer-related intracerebral hemorrhage. 36 We also found that the NLR in the tumor group was relatively lower than that in the control group. Immune-associated inflammation also plays an important role in ICH-induced brain injury and malignant tumors.…”

Section: Discussionmentioning

confidence: 50%

Clinical Characteristics and Risk Factors of Cerebral Hemorrhage in Patients with Occult Malignant Tumors

Zhao¹,

Xie²,

Pan³

et al. 2021

NDT

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Propose To investigate the clinical characteristics and potential risk factors of the first onset of cerebral hemorrhage in patients with occult malignant tumors. Patients and methods In this retrospective study, 23 patients with occult malignant tumors with the first onset of cerebral hemorrhage were enrolled in the tumor group, and 92 patients without occult tumors in the same period were enrolled in the control group. There were no statistical differences in age and sex between both groups by propensity score matching. Collected clinical data included age, sex, smoking history, drinking history, hypertension history, diabetes history, past medical history, routine blood tests, neutrophil-to-lymphocyte ratio (NLR), liver and kidney function, fasting blood glucose level, coagulation function, tumor markers, imaging examinations, National Institute of Health stroke scale (NIHSS) score on admission, modified Rankin Scale (mRS) score 90 days after intracerebral hemorrhage and final mRS score. Results Compared with the control group, the tumor group had fewer patients with hypertension (52.2% vs 81.5%, P <0.05), and the NLR was significantly decreased in the tumor group (2.74 vs 5.46, P <0.05). The tumor group had a greater number of patients with the bleeding sites located in the lobar regions (43.5% vs.19.6%, P <0.05) and a higher coagulation dysfunction (52.2% vs 29.3%, P <0.05) than the control group. Multivariate logistic regression analysis revealed that no history of hypertension (OR: 3.141, 95% CI: 1.107–8.916), lobar cerebral hemorrhage (OR: 3.465 95% CI:1.172–10.243), and coagulation dysfunction (OR: 3.176, 95% CI: 1.131–8.913) were independent predictors of occult tumors, and the receiver operating characteristic (ROC) curve showed that the area under the curve of the three-index combined diagnosis was 0.748, C-statistic analysis also showed the same result. Conclusion No history of hypertension, lobar cerebral hemorrhage, and coagulation dysfunction may be predictors of the risk of occult malignancies in patients with cerebral hemorrhage.

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“…Clinical typing can serve the treatment, and provide different treatment options to the families of patients [29]. On the one hand, the purpose of surgical treatment is to remove the hematoma, to reduce the primary injury and secondary injury caused by the hematoma to the brain stem, and on the other hand, to relieve the obstruction of the cerebrospinal fluid circulation system, and to reduce the excessive cranial pressure [20,27]. At present, the previous surgical schemes for brainstem haemorrhage include microscopic craniotomy and hematoma removal, stereotactic (ROSA robot) hematoma puncture and drainage, external ventricular drainage and other surgery [14].…”

Section: Introductionmentioning

confidence: 99%

Development and initial experience of a novel classification system for patients with brain stem haemorrhage

Li,

Wang,

Zhang

et al. 2023

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Introduction: There is no uniform classification standard for brain stem haemorrhage. On the basis of previous experience in the treatment of brainstem haemorrhage, this study explored and established a set of criteria for brainstem haemorrhage classification, risk-stratified such patients and guided the selection of treatment options so as to achieve accurate and standardized diagnosis and treatment. Material and methods: Thirty patients with brainstem haemorrhage from April 2019 to May 2022 were included. According to the amount and location of the brain stem bleeding, it was divided into the following types: small haemorrhage type (type 1), medium haemorrhage type (lateral type 2a, dorsal type 2b, ventral type 2c), and large haemorrhage type (type 3), and the preoperative condition and postoperative outcome within 3 months were evaluated. Results: The included 30 patients with brainstem haemorrhage were aged 53.2 ±13.8 years old, and 80% were men. Among them, 5 patients were type 1 (16.7%), 2 patients type 2a (6.7%), 7 patients type 2b (23.3%), 5 patients type 2c (16.7%) and 11 patients type 3 (36.7%). The prognosis among these subtypes was significantly different (p < 0.001). All type 1 patients were cured, with the highest mortality rate in type 2c patients (100%). Compared with type 2b (5.5 ±3.5 days) and type 2c (3.4 ±2.5 days), type 3 patients tended to have fewer days to die (2.9 ±2.7 days). The difference in NIHSS scores was significant among surviving patients (p < 0.001). Type 1 is the lowest at 1.8 ±2.2 points; type 3 is the highest at 35.0 ±3.5 points. Conclusions: Relying on the anatomical basis and treatment plan, we propose a different classification, which is conducive to quickly identifying the haemorrhage type and degree of disease, and putting forward an appropriate treatment plan, which is expected to improve the patient prognosis.

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Surgical treatment of spontaneous intracranial hemorrhage in patients with cancer: Analysis of prognostic factors

Cited by 6 publications

References 19 publications

Predictive Nomogram for Unfavorable Outcome of Spontaneous Intracerebral Hemorrhage

Predictive Nomogram for Unfavorable Outcome of Spontaneous Intracerebral Hemorrhage

Clinical Characteristics and Risk Factors of Cerebral Hemorrhage in Patients with Occult Malignant Tumors

Development and initial experience of a novel classification system for patients with brain stem haemorrhage

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