High prevalence of cognitive impairment after intracerebral hemorrhage

Planton, Mélanie; Saint‐Aubert, Laure; Raposo, Nicolas; Branchu, L.; Lyoubi, Aïcha; Bonneville, Fabrice; Albucher, Jean‐François; Olivot, Jean‐Marc; Péran, Patrice; Pariente, Jérémie

doi:10.1371/journal.pone.0178886

Cited by 34 publications

(41 citation statements)

References 23 publications

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“…Hypertensive angiopathy (HA) and cerebral amyloid angiopathy (CAA) are common small vessel diseases (SVDs) that account for most cases of spontaneous intracerebral hemorrhage (ICH) (1), the most severe stroke subtype with high risk of mortality and dementia (2, 3). CAA results from amyloid-β (Aβ) deposition in the wall of cortical and leptomeningeal vessels and is a common cause of lobar ICH.…”

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confidence: 99%

Underlying Small Vessel Disease Associated With Mixed Cerebral Microbleeds

et al. 2019

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Background and Purpose: Whether patients with both lobar and deep cerebral microbleeds (mixed CMB) have advanced cerebral amyloid angiopathy (CAA), hypertensive angiopathy (HA) or both is uncertain. To get insight into the underlying small vessel disease (SVD) associated with mixed CMB, we explored its association with cortical superficial siderosis (cSS), a key marker of CAA and other MRI markers of SVD in patients with intracerebral hemorrhage (ICH).Methods: Of 425 consecutive patients with acute ICH who had received brain MRIs, 260 had ≥1 CMB and were included in the analysis. They were categorized as strictly lobar CMB (suggesting CAA), strictly deep CMB (suggesting HA) or mixed CMB. Clinical and imaging characteristics were compared (1) between the three CMB groups and (2) within mixed CMB patients according to the symptomatic ICH location.Results: Overall, 111 (26%) patients had mixed CMB. Compared to strictly lobar CMB (n = 111) and strictly deep CMB (n = 38), patients with mixed CMB had a more severe burden of lacune, white matter hyperintensities and CMB. cSS was observed in 24.3% of patients with mixed CMB compared to 44.1% in strictly lobar CMB and 10.5% in strictly deep CMB (p < 0.0001). Among patients with mixed CMB, 44 (39.6%) had a lobar symptomatic ICH and 67 (60.4%) had a non-lobar ICH. Patients with non-lobar ICH were more likely to have hypertension, whereas those with lobar ICH were more likely to have cSS and chronic lobar ICH and had higher ratio lobar CMB count/total CMB count.Conclusions: Mixed CMB is frequently encountered in patients with ICH and appears as a heterogeneous group, suggesting that both CAA and HA may be contributing to mixed CMB. Neuroimaging markers including ICH location, cSS, and CMB distribution may indicate the predominant underlying vasculopathy, with potential prognostic implications.

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Section: Introductionmentioning

confidence: 99%

Underlying Small Vessel Disease Associated With Mixed Cerebral Microbleeds

et al. 2019

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“…Ischemic stroke represents a common cause of dementia, reduced cognitive function, and neurological deficits in later years either alone or in concurrence with other pathologies [27, 28]. This study used the permanent occlusion of the right middle cerebral artery model (Rt.MCAO) to investigate an experimental therapy.…”

Section: Discussionmentioning

confidence: 99%

Baihui Point Laser Acupuncture Ameliorates Cognitive Impairment, Motor Deficit, and Neuronal Loss Partly via Antioxidant and Anti-Inflammatory Effects in an Animal Model of Focal Ischemic Stroke

Jittiwat

2019

Evidence-Based Complementary and Alternative Medicine

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Stroke is recognized as one of the most dangerous killer diseases in Thailand and other countries worldwide. The development of a novel strategy for treating stroke patients is therefore urgently required. The present study investigated the effect of laser acupuncture at the Baihui point on cognitive and functional recovery, neuronal loss, antioxidant enzyme activities, and interleukin-6 (IL-6) activity in the hippocampus in an animal model of focal ischemic stroke. Male Wistar rats were randomly divided into 4 groups: sham operation; permanent occlusion of the right middle cerebral artery (Rt.MCAO); Rt.MCAO with sham laser acupuncture; and Rt.MCAO with Baihui point laser acupuncture. Laser acupuncture at the Baihui point and sham acupuncture at a nonacupoint were performed once daily (10 min at each point) for 14 days after Rt.MCAO. Half of the rats in each group were examined to determine neuron density by Cresyl violet staining, while the other half were examined by biochemical assays to measure glutathione peroxidase (GSH-Px) in the hippocampus, superoxide dismutase (SOD) in mitochondria and interleukin-6 (IL-6) activity in the hippocampus. Laser acupuncture treatment was found to significantly enhance memory and neuron density in CA1 and CA3. Improved neurological score, improved GSH-Px and SOD activities, and decreased density ratio of IL-6 to β-actin were also observed in the hippocampus. In conclusion, Baihui point laser acupuncture alleviates cognitive impairment and motor deficits via antioxidant and anti-inflammatory effects in focal ischemic rats. Further study is warranted to investigate other possible mechanisms of action.

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“…Beside the high rate of mortality and morbidity with high lifetime costs, cognitive impairment and depression appear frequently in patients with spontaneous ICH. [7,8] Other causes for ICH are vascular pathologies, including AVMs. The annual bleeding risk of AVMs amounts 1% to 4% and mostly affects young patients.…”

Section: Introductionmentioning

confidence: 99%

Differences in bleeding patterns and outcome after intracerebral hemorrhage due to vascular malformations

et al. 2019

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Background Atypical intracerebral hemorrhage is a common form of primary manifestation of vascular malformations. Objective The aim of the present study is to determine clues to the cause of bleeding according to hemorrhage pattern (lobar, basal ganglia, infratentorial). Methods We retrospectively evaluated 343 consecutive neurosurgical patients with intracerebral hemorrhage (ICH), who were admitted to our neurosurgical department between 2006 and 2016. The study cohort includes only neurosurgical patients. Patients who underwent treatment by neurologists are not represented in this study. We assessed location of hemorrhage, hematoma volumes to rule out differences and predicitve variables for final outcome. Results In 171 cases (49.9%) vascular malformations, such as arteriovenous malformations (AVMs), cavernomas, dural fistulas and aneurysms were the cause of bleeding. 172 (50.1%) patients suffered from an intracerebral hemorrhage due to amyloid angiopathy or long standing hypertension. In patients with infratentorial hemorrhage a malformation was more frequently detected as in patients with supratentorial hemorrhage (36% vs. 16%, OR 2.9 [1.8;4.9], p<0.001). Among the malformations AVMs were most common (81%). Hematoma expansion was smaller in vascular malformation than non-malformation caused bleeding (24.1 cm 3 vs. 64.8 cm 3 , OR 0.5 [0.4;0.7], p < 0.001,). In 6 (2.1%) cases diagnosis remained unclear. Final outcome was more favorable in patients with vascular malformations (63% vs. 12%, OR 12.8 [4.5;36.2], p<0.001). Conclusion Localization and bleeding patterns are predictive factors for origin of the hemorrhage. These predictive factors should quickly lead to appropriate vascular diagnostic measures. However, due to the inclusion criteria the validity of the study is limited and multicentre studies with further testing in general ICH patients are required.

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High prevalence of cognitive impairment after intracerebral hemorrhage

Cited by 34 publications

References 23 publications

Underlying Small Vessel Disease Associated With Mixed Cerebral Microbleeds

Underlying Small Vessel Disease Associated With Mixed Cerebral Microbleeds

Baihui Point Laser Acupuncture Ameliorates Cognitive Impairment, Motor Deficit, and Neuronal Loss Partly via Antioxidant and Anti-Inflammatory Effects in an Animal Model of Focal Ischemic Stroke

Differences in bleeding patterns and outcome after intracerebral hemorrhage due to vascular malformations

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