Death and functional outcome after spontaneous intracerebral hemorrhage. A prospective study of 166 cases using multivariate analysis.

Daverat, P.; Castel, Jean-Pierre; Dartigues, J. F.; Orgogozo, J. M.

doi:10.1161/01.str.22.1.1

Cited by 351 publications

(205 citation statements)

References 19 publications

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“…" The independent indicators for early death in our study were: pineal gland displacement, a high blood glucose level on admission (8 mmol/l or more), the eye and motor score on the GCS, and the haematoma volume. Some previous studies with multivariate analysis in patients with ICH found other indicators for prognosis, but these determined outcome on discharge,4 at 306 9 results also confirm previous studies about incontinence in patients two weeks after stroke as a predictive factor for one year mortality 23 24 The patients with ICH who survived the first two days had a similar outcome as patients with CI who were matched according to Rankin grade, age and level of consciousness. This similarity applies to the proportion of dependent patients during follow up as well as to the number of patients who died and the causes of death.…”

Section: Discussionsupporting

confidence: 72%

Prognostic factors in patients with intracerebral haematoma.

Franke

Swieten

Algra

et al. 1992

Journal of Neurology, Neurosurgery & Psychiatry

189

105

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In a prospective study, the prognostic value of clinical characteristics in 157 consecutive patients with spontaneous supratentorial intracerebral haemorrhage were examined by means of multivariate analysis.Two days after the event 37 (24%) patients had died. Factors independently contributing to the prediction of two day mortality were pineal gland displacement on CT of 3 mm or more (p < 0-001), blood glucose level on admission of 8-0 mmolIl or more (p = 0-01), eye and motor score on the Glasgow Coma Scale of eight out of 10 or less (p = 0.022) and haematoma volume of 40 cm3 or more (p = 0.037).Between the third day and one year after the event another 46 of the 120 two day survivors had died; the independent prognostic indicators for death during that period were: age 70 years or more (p < 0-001) and severe handicap (Rankin grade five) on the third day (p < 0-001). Functional independence (Rankin grade two or less) at one year was most common not only with the converse features of age less than 70 years (p < 0-01) and Rankin grade four or less on the third day (p = 0.002), but also with an eye and motor score on the Glasgow Coma Scale of nine or 10 on the third day (p < 0.001).The 120 patients with intracerebral haemorrhage who were still alive two days after the event were matched with 120 patients with cerebral infarction, according to age, level of consciousness on the third day after stroke (Glasgow Coma Scale) and handicap (Rankin grade). Survival and handicap after one year did not differ between these two groups. The conclusion drawn is that it is not the cause (intracerebral haemorrhage or cerebral infarction) but the extent of the brain lesion that determines the outcome in patients who survive the first two days. (7 Neurol Neurosurg Psychiatry 1992;55:653-657)

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Section: Discussionsupporting

confidence: 72%

Prognostic factors in patients with intracerebral haematoma.

Franke

Swieten

Algra

et al. 1992

Journal of Neurology, Neurosurgery & Psychiatry

189

105

View full text Add to dashboard Cite

show abstract

“…For instance, in a prospective study that included 166 patients with spontaneous supratentorial ICH, Daverat and colleagues (22) found that age is the key predictor of functional outcome after ICH in human beings. In this study, Daverat et al (22) showed no significant difference between males and females in the clinical outcome; neither the hemisphere side nor the anatomic localization of the hematoma was estimated as significant variables that contribute to the clinical outcome. All of these results are in good agreement with our Macedonian experience.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcome in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage

Rendevski¹,

Stojanov²,

Aleksovski³

et al. 2017

Acta Facultatis Medicae Naissensis

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The aim of the paper was to evaluate the surgical outcome in patients with spontaneous supratentorial intracerebral hemorrhage (ICH) after surgical intervention, in respect to the initial clinical conditions, age, sex, hemispheric side and anatomic localization of ICH. Thirty-eight surgically treated patients with spontaneous supratentorial intracerebral hemorrhage were included in the study. The surgical outcome was evaluated three months after the initial admission, according to the Glasgow Outcome Scale (GOS). The surgical treatment was successful in 14 patients (37%), whereas it was unsuccessful in 24 patients (63%). We have detected a significant negative correlation between the Glasgow Coma Scale (GCS) scores on admission and the GOS scores after three months, suggesting worse neurological outcome in patients with initially lower GCS scores. The surgical outcome in patients with ICH was not affected by the sex, the hemispheric side and the anatomic localization of ICH, but the age of the patients was estimated as a significant factor for their functional outcome, with younger patients being more likely to be treated successfully. The surgical outcome is affected from the initial clinical state of the patients and their age. The treatment of ICH is still an unsolved clinical problem and the development of new surgical techniques with larger efficiency in the evacuation of the hematoma is necessary, thus making a minimal damage to the normal brain tissue, as well as decreasing the possibility of postoperative bleeding.

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“…When compared with young rats, ICH in aged rats causes more profound neurologic deficits, autophagy, brain swelling, microglial activation, and induction of heat shock proteins (Gong et al, 2004(Gong et al, , 2011. Age is an important predictor of functional outcome (Daverat et al, 1991), and thus likely to be a significant determinant of brain injury, following ICH in humans. Importantly, aged rats exhibit a different quantitative and temporal inflammatory profile compared with their younger counterparts (Wasserman et al, 2008).…”

Section: Age and Comorbiditymentioning

confidence: 99%

Experimental Intracerebral Hemorrhage: Avoiding Pitfalls in Translational Research

Kirkman

Allan

Parry‐Jones

2011

J Cereb Blood Flow Metab

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Intracerebral hemorrhage (ICH) has the highest mortality of all stroke subtypes, yet treatments are mainly limited to supportive management, and surgery remains controversial. Despite significant advances in our understanding of ICH pathophysiology, we still lack preclinical models that accurately replicate the underlying mechanisms of injury. Current experimental ICH models (including autologous blood and collagenase injection) simulate different aspects of ICH-mediated injury but lack some features of the clinical condition. Newly developed models, notably hypertension-and oral anticoagulant therapy-associated ICH models, offer added benefits but further study is needed to fully validate them. Here, we describe and discuss current approaches to experimental ICH, with suggestions for changes in how this condition is studied in the laboratory. Although advances in imaging over the past few decades have allowed greater insight into clinical ICH, there remains an important role for experimental models in furthering our understanding of the basic pathophysiologic processes underlying ICH, provided limitations of animal models are borne in mind. Owing to differences in existing models and the failed translation of benefits in experimental ICH to clinical practice, putative neuroprotectants should be trialed in multiple models using both histological and functional outcomes until a more accurate model of ICH is developed.

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Death and functional outcome after spontaneous intracerebral hemorrhage. A prospective study of 166 cases using multivariate analysis.

Cited by 351 publications

References 19 publications

Prognostic factors in patients with intracerebral haematoma.

Prognostic factors in patients with intracerebral haematoma.

Surgical Outcome in Patients with Spontaneous Supratentorial Intracerebral Hemorrhage

Experimental Intracerebral Hemorrhage: Avoiding Pitfalls in Translational Research

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