Early neurologic deterioration in intracerebral hemorrhage

Leira, Rogelio; Dávalos, Antonio; Silva, Y.; Gil-Peralta, A; Tejada, J.; García, M.; Castillo, José

doi:10.1212/01.wnl.0000133204.81153.ac

Cited by 452 publications

(289 citation statements)

References 30 publications

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“…These observations are in agreement not only with previous studies of WBC count [12,14,31,32]. But also with studies of other inflammatory markers [9,10,13,37].…”

Section: Discussionsupporting

confidence: 93%

“…An elevated WBC count was associated with hematoma size [31,32]. Predicted early neurologic deterioration, worse outcome and mortality after sICH [12,14,30,31].…”

Section: Discussionmentioning

confidence: 99%

“…Several prospective studies have been indicated that brain injury secondary to a sICH is characterized by acute local inflammation deterioration in sICH [11,12]. Another of the most promising of these inflammatory markers is C-reactive protein (CRP), a biomarker of inflammation that has been shown to predict prognosis in ischemic stroke after adjustment for all major prognostic components [15].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Relationship between Baseline White Blood Cell and C-Reactive Protein with Mortality in Patients with Spontaneous Intracerebral Hemorrhage

Godoy¹,

Papa²,

Campi³

et al. 2010

J Neurol Neurophysiol

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“…These observations are in agreement not only with previous studies of WBC count [12,14,31,32]. But also with studies of other inflammatory markers [9,10,13,37].…”

Section: Discussionsupporting

confidence: 93%

“…An elevated WBC count was associated with hematoma size [31,32]. Predicted early neurologic deterioration, worse outcome and mortality after sICH [12,14,30,31].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Relationship between Baseline White Blood Cell and C-Reactive Protein with Mortality in Patients with Spontaneous Intracerebral Hemorrhage

Godoy¹,

Papa²,

Campi³

et al. 2010

J Neurol Neurophysiol

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“…Hypothermia is an established neuroprotectant in cerebral ischemia, but data in ICH models are inconclusive (MacLellan et al, 2009a(MacLellan et al, , 2010. Interestingly, hyperthermia protocols that aggravate ischemic brain injury (e.g., elevating temperature to 391C for 3 hours) cause no harmful effects in ICH models (MacLellan and Colbourne, 2005;Penner et al, 2011), while clinical data on post-ICH fever are inconclusive (Leira et al, 2004;Schwarz et al, 2000;Szczudlik et al, 2002;Wang et al, 2000Wang et al, , 2008a. At least for striatal ICH, both collagenase and whole blood models do not appear to spontaneously cause postoperative changes in temperature when measured via telemetry probes (MacLellan et al, 2004(MacLellan et al, , 2006b), but different results may occur in mice or in animals with more severe insults, drug treatments, or different surgical techniques (e.g., nonsterile surgery) than we used.…”

Section: Physiological Variablesmentioning

confidence: 99%

A Critical Appraisal of Experimental Intracerebral Hemorrhage Research

MacLellan

Paquette

Colbourne

2012

J Cereb Blood Flow Metab

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The likelihood of translating therapeutic interventions for stroke rests on the quality of preclinical science. Given the limited success of putative treatments for ischemic stroke and the reasons put forth to explain it, we sought to determine whether such problems hamper progress for intracerebral hemorrhage (ICH). Approximately 10% to 20% of strokes result from an ICH, which results in considerable disability and high mortality. Several animal models reproduce ICH and its underlying pathophysiology, and these models have been widely used to evaluate treatments. As yet, however, none has successfully translated. In this review, we focus on rodent models of ICH, highlighting differences among them (e.g., pathophysiology), issues with experimental design and analysis, and choice of end points. A Pub Med search for experimental ICH (years: 2007 to 31 July 2011) found 121 papers. Of these, 84% tested neuroprotectants, 11% tested stem cell therapies, and 5% tested rehabilitation therapies. We reviewed these to examine study quality (e.g., use of blinding procedures) and choice of end points (e.g., behavioral testing). Not surprisingly, the problems that have plagued the ischemia field are also prevalent in ICH literature. Based on these data, several recommendations are put forth to facilitate progress in identifying effective treatments for ICH.

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“…4,12,13 The 30-day mortality rate for patients with IVH is nearly 5 times higher than those with ICH alone. 14 We think there are several reasons for the high mortality rate and disability rate of IVH: first, a vicious cycle of acute increased ICP inducing fatal brain hernia 15 ; second, potential triggering of cerebral vasospasm by vasoactive agents arising from or released by the hemorrhage, such as serotonin, prostaglandins, catecholamines, angiotensin, oxyhemoglobin, endothelin, calcium ion, protein kinase C, thromboxane A2 (TxA2), substance P, histamine, hypothalamus exudate, biogenic amines and peptides, fatty peroxides, and free radicals 16,17 ; third, secondary brain edema; and fourth, acute obstructive hydrocephalus.…”

Section: Discussionmentioning

confidence: 99%

Rapid Pore Cranial Drilling With External Ventricular Drainage for Treatment of Intraventricular Hemorrhage: A 36-Year Case Series

Zhang

Lin

et al. 2015

International Surgery

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This study aimed to describe the technique details of rapid pore cranial drilling with external ventricular drainage and document its clinical outcomes by highlighting the advantages over the traditional and modified cranial drilling technique. Intraventricular hemorrhage is one of the most severe subtypes of hemorrhagic stroke with high mortality. The amount of blood in the ventricles is associated with severity of outcomes, and fast removal of the blood clot is the key to a good prognosis. Between 1977 and 2013, 3773 patients admitted for intraventricular hemorrhage underwent rapid pore cranial drilling drainage. The therapeutic effects and clinical outcomes were retrospectively analyzed. Of these patients, 1049 (27.8%) experienced complete remission, 1788 (47.4%) had improved condition, and 936 (24.8%) died. A total of 3229 (85.6%) patients gained immediate remission. One typical case was illustrated to demonstrate the efficacy of the rapid pore drilling technique. Rapid pore cranial drilling drainage in patients with intraventricular hemorrhage is fast, effective, and provides immediate relief in patients with severe conditions. It could be a better alternative to the conventional drilling approach for treatment of intraventricular hemorrhage. A randomized controlled trial for direct comparison between the rapid pore cranial drilling drainage and conventional drilling technique is in urgent need.

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Early neurologic deterioration in intracerebral hemorrhage

Abstract: Clinical and biologic markers of the inflammatory reaction on admission are predictors of subsequent END, whereas early ICH growth, intraventricular bleeding, and high systolic blood pressure within 48 hours are factors associated with END in patients with spontaneous ICH.

Cited by 452 publications

References 30 publications

Relationship between Baseline White Blood Cell and C-Reactive Protein with Mortality in Patients with Spontaneous Intracerebral Hemorrhage

Relationship between Baseline White Blood Cell and C-Reactive Protein with Mortality in Patients with Spontaneous Intracerebral Hemorrhage

A Critical Appraisal of Experimental Intracerebral Hemorrhage Research

Rapid Pore Cranial Drilling With External Ventricular Drainage for Treatment of Intraventricular Hemorrhage: A 36-Year Case Series

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