Intracerebral Hemorrhage

Abstract

Intracerebral hemorrhage (ICH) is associated with a higher mortality rate among stroke subtypes. The amount of hematoma at baseline and subsequent expansion are considered strong independent markers for determining poor clinical outcome. Even though reduction in blood pressure to prevent and control the amount of bleeding in ICH has received considerable amount of attention, the impact of coagulopathy and platelet dysfunction, on the bleeding diathesis has not been extensively investigated. With the increasing use of antiplatelets and/or anticoagulants, given the aging population, a deeper understanding of the interactions between ICH and hemostatic mechanisms is essential to help minimize the risk of a catastrophic coagulopathy-related ICH. In this review article, etiology and risk factors associated with coagulopathy-related ICH are discussed. An overview of coagulation abnormalities, hemostatic agents, and blood biomarkers pertaining to ICH is included.

Hemostatic Markers and Long-Term Risk of Intracerebral Hemorrhage in Postmenopausal Women

“…Consistent associations have been reported with ICH and use of anticoagulant agents [3]. Both warfarin [1,2,5] and aspirin [1,2,6] have been associated with an increased risk of ICH.…”

“…Notably, mortality and morbidity of ICH are high (up to 50% at 30 days). Therefore, efforts to identify high-risk individuals could be especially important and useful in developing early preventive approaches [1-3]. In this regard, previous studies have identified older age, higher alcohol intake, hypertension, male sex, current smoking, and diabetes as risk factors [4] for the development of ICH.…”

“…Both warfarin [1,2,5] and aspirin [1,2,6] have been associated with an increased risk of ICH. Patients with inherited or acquired bleeding disorders also have a higher risk of ICH compared to those without bleeding disorders [3,7-11]. In long-term cohort studies, Von Willebrand Factor (VWF) has been examined in 2 studies, but results were inconsistent [10,12].…”

Efficacy and Safety of Panax notoginseng Saponin Therapy for Acute Intracerebral Hemorrhage, Meta-Analysis, and Mini Review of Potential Mechanisms of Action

“…Intrahematomal blood clotting is also a pathogenetic factor in hyperacute perihematomal edema formation ( 111 ). There is an increasing use of anti-platelets and/or anti-coagulants in the treatment of blood clotting and hyperviscosity in ICH and there is some evidence of therapeutic effects in animal models of ICH ( 112 – 115 ). Several compounds of PNS including adenosine and guanosine, ginsenoside Rh1, F1, Rg1, and Rg2 have anti-platelet and anti-coagulant activities, with adenosine and guanosine and the ginsenosides as the main anti-platelet aggregation compounds of PNS ( 116 – 118 ).…”

Biomarkers of Cardiovascular Disease

“…Повышенные сывороточные уровни СРБ коррелируют с объемом гематом и повышенной смертностью. Уровень D-димера ассоциирован с объемом кровоизлияния и внутрижелудочковым или субарахноидальным распространением, ранним неврологическим ухудшением и смертью в течение первой недели [34]. Сравнение транскриптомов крови пациентов с ии и Ги выявило различия в экспрессии ряда факторов.…”