Intracerebral Hemorrhage in Young People

Ruiz-Sandoval, José Luís; Cantú, Carlos; Barinagarrementería, Fernando

doi:10.1161/01.str.30.3.537

Cited by 202 publications

(103 citation statements)

References 49 publications

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“…Important precipitating/contributing factors may include acute hypertension, abnormal coagulation, and thrombolysis. Amyloid angiopathy increases in incidence with age (Miller et al, 1999), whereas in young patients with ICH, vascular malformations predominate (Ruiz-Sandoval et al, 1999). While hypertension is the biggest risk factor for ICH, other risk factors include alcohol consumption, diabetes, the menopause, and cigarette smoking (Feldmann et al, 2005).…”

Section: A Heterogeneous Condition With Multiple Etiologiesmentioning

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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Section: A Heterogeneous Condition With Multiple Etiologiesmentioning

confidence: 99%

Experimental Intracerebral Hemorrhage: Avoiding Pitfalls in Translational Research

Kirkman

Allan

Parry‐Jones

2011

J Cereb Blood Flow Metab

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“…8 Ephedrine, pseudoephedrine, and phencyclidine have also been described in association with SICH. 109 Ginkgo biloba is an over-the-counter herbal extract used by many people in the US and Europe as a "memory aid;" several case reports have described an association between its use and ICH. 78 A possible antiplatelet effect and Coumadin potentiation mechanism has been postulated.…”

Section: Causes Of Sichmentioning

confidence: 99%

Spontaneous intracerebral hemorrhage: a review

Fewel¹,

Thompson²,

Hoff³

2003

FOC

143

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Spontaneous intracerebral hemorrhage (SICH) is a blood clot that arises in the brain parenchyma in the absence of trauma or surgery. This entity accounts for 10 to 15% of all strokes and is associated with a higher mortality rate than either ischemic stroke or subarachnoid hemorrhage. Common causes include hypertension, amyloid angiopathy, coagulopathy, vascular anomalies, tumors, and various drugs. Hypertension, however, remains the single greatest modifiable risk factor for SICH. Computerized tomography scanning is the initial diagnostic modality of choice in SICH, and angiography should be considered in all cases except those involving older patients with preexisting hypertension in thalamic, putaminal, or cerebellar hemorrhage. Medical management includes venous thrombosis prophylaxis, gastric cytoprotection, and aggressive rehabilitation. Anticonvulsant agents should be prescribed in supratentorial SICH, whereas the management of hypertension is controversial. To date, nine prospective randomized controlled studies have been conducted to compare surgical and medical management of SICH. Although definitive evidence favoring surgical intervention is lacking, there is good theoretical rationale for early surgical intervention. Surgery should be considered in patients with moderate to large lobar or basal ganglia hemorrhages and those suffering progressive neurological deterioration. Elderly patients in whom the Glasgow Coma Scale score is less than 5, those with brainstem hemorrhages, and those with small hemorrhages do not typically benefit from surgery. Patients with cerebellar hemorrhages larger than 3 cm, those with brainstem compression and hydrocephalus, or those exhibiting neurological deterioration should undergo surgical evacuation of the clot. It is hoped that the forthcoming results of the International Surgical Trial in IntraCerebral Hemorrhage will help formulate evidence-based recommendations regarding the role of surgery in SICH.

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“…En cuanto a la etiología de las hemorragias intracerebrales la mitad correspondió a malformaciones vasculares, lo que concuerda con otros estudios (16) . Dentro de ellas la más frecuente fue la MAV, seguida del angioma cavernoso.…”

Section: Discussionunclassified

“…La mayor frecuencia correspondió a la topografía lobar y dentro de ellas a la región frontal, hecho vinculado al menor número de casos con etiología hipertensiva y a la mayor frecuencia de malformaciones vasculares, las cuales tienden a localizarse en topografías superficiales; estando estos datos en concordancia con los estudios publicados y analizados (16) . Conclusiones 1) El ACV en el joven correspondió al 5,6% de todos los ACV.…”

Section: Discussionunclassified

Análisis de una Cohorte de Pacientes con ACV del Joven. Hospital de Clínicas, Montevideo.

Higgie

Urban

Hackembruch

et al. 2018

Rev. urug. med. interna

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Analysis of a cohort of patients with young man's stroke. Hospital of Clinics, Montevideo.Análise de uma coorte de pacientes com AVC do jovem. Hospital de Clínicas, Montevidéu.Resumen: Introducción. El ataque cerebro-vascular (ACV) es un importante problema de salud pública. Se define ACV en el joven a aquel que se presenta entre los 15-45 años. El objetivo primario de este trabajo es describir las características epidemiológicas, clínicas, imagenológicas, etiopatogénicas y terapéuticas de los pacientes con ACV en el joven. Materiales y Métodos. Se trata de un estudio retrospectivo y descriptivo, acerca de una cohorte de pacientes que presentaron ACV en el joven asistidos en el Hospital de Clínicas de Montevideo en el período comprendido entre junio de 2007 y junio de 2014. Resultados. Se incluyeron 50 pacientes que representaron el 5,6 % de todos los ACV en el período comprendido en el estudio. La media de edad fue de 33 años. En cuanto a la naturaleza, el 64% fueron isquémicos y el 36% hemorrágicos. Según la clasificación TOAST, la etiología más frecuente fue la criptogenética (34%). Respecto a la etiología de las hemorragias intracerebrales la mitad correspondió a malformaciones vasculares. Discusión. El porcentaje de ACV del joven fue algo menor que el descrito en otras comunicaciones. Comparado con el ACV en todas las edades, la hemorragia cerebral aumenta su proporción, si bien la naturaleza isquémica sigue predominando. La causa más frecuente de ACV isquémico del joven fue la criptogenética, seguida de la cardioembolia y las causas inhabituales. Las disecciones arteriales igualaron en prevalencia a la ateromatosis de grandes vasos. Este hecho es similar a lo descrito por la mayoría de los autores. Si bien la etiología más prevalente de hemorragia parenquimatosa fueron las malformaciones vasculares, la cantidad de hematomas hipertensivos no fue despreciable a estas edades.Palabras clave: Unidad ACV, ACV, joven.Abstract: Introduction. Stroke is an important public health issue. Stroke in the young is defined as the one who presents between 15 and 45 years old. The primary objective of this study is to describe the epidemiological, clinical, imaging, etiopathogenic and therapeutic characteristics of stroke in young patients. Materials and Methods. This was a retrospective and descriptive study of a cohort of patients who presented with stroke in the young assisted at the Hospital de Clínicas in Montevideo in the period between June 2007 and June 2014. Results. We have included fifty patients which accounted for 5.6% of all stroke in the period covered by the study. The mean age was 33 yo. As for nature, 64% were ischemic and 36% hemorrhagic. According to the TOAST classification, the most common etiology was cryptogenetic (34%). Regarding the etiology of intracerebral hemorrhages, half corresponded to vascular malformations. Discussion. The proportion of stroke in young people was somewhat lower than that described in other communications. Compared with stroke in all ages, cerebral hemorrhage increases its p...

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Intracerebral Hemorrhage in Young People

Cited by 202 publications

References 49 publications

Experimental Intracerebral Hemorrhage: Avoiding Pitfalls in Translational Research

Experimental Intracerebral Hemorrhage: Avoiding Pitfalls in Translational Research

Spontaneous intracerebral hemorrhage: a review

Análisis de una Cohorte de Pacientes con ACV del Joven. Hospital de Clínicas, Montevideo.

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