Hematoma growth is a determinant of mortality and poor outcome after intracerebral hemorrhage

Abstract

Hematoma growth is an independent determinant of both mortality and functional outcome after intracerebral hemorrhage. Attenuation of growth is an important therapeutic strategy.

Intracerebral Hemorrhage Score and Volume as an Independent Predictor of Mortality in Primary Intracerebral Hemorrhage Patients

“…The use of a scale such as the ICH score could improve standardization of clinical treatment protocols and clinical research studies in ICH [5].…”

Therapeutic Strategies in Acute Intracerebral Hemorrhage

“…In addition, it predicts poor functional outcome [13,14]. The apolipoprotein E ε2 allele is associated with larger hematomas, which appears to explain its effect on outcome [15].…”

“…Seventy three percent of patients express some degree of expansion, and 30 to 40% of patients expand more than 33% from baseline volume [13,18,30,31]. The pathophysiological mechanism by which hematoma expansion occurs remains unclear.…”

“…Hematoma expansion strongly influences outcome, with each 10% enlargement of the hematoma resulting in a 5% increased hazard of death, and an increase of 16% in the likelihood of 1 point worsening on the modified Rankin Scale [13]. Other studies also showed increased risks of poor functional outcome and death [16,30,33].…”

Treatment Targets in Intracerebral Hemorrhage

“…In addition, treatment efforts are directed at halting hematoma expansion. Because HE occurs in approximately a third of ICH patients, and because it is independently associated with worsening of clinical status and outcome [54], HE represents a promising acute treatment target.…”