Location-specific risk factors for intracerebral hemorrhage

Jolink, Wilmar M.T.; Wiegertjes, Kim; Rinkel, Gabriël J.E.; Algra, Ale; Leeuw, Frank‐Erik de; Klijn, Catharina J.M.

doi:10.1212/wnl.0000000000010418

Cited by 48 publications

(42 citation statements)

References 47 publications

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“…Jolink et al also confirmed that hypertension was associated with the high risk of ICH. Male gender was more likely to be attacked by ICH which might be due to excessive drinking [ 37 ]. A systematic review and meta-analysis of intracerebral hemorrhage have indicated that the incidence of ICH increased with age, especially in patients above 45 years of age, and the incidence rate of males is higher than that of the female patients [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

DNA Hypomethylation of DOCK1 Leading to High Expression Correlates with Neurologic Deterioration and Poor Function Outcomes after Spontaneous Intracerebral Hemorrhage

Gao

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Objective. Spontaneous intracerebral hemorrhage (ICH) is a blood clot arising in the brain parenchyma in the absence of trauma or surgery and accounts for 10% to 15% of all strokes, leading to higher rates of mortality and morbidity than either ischemic stroke or subarachnoid hemorrhage. We sought to investigate the potential association of DOCK1 with neurological deficits and outcomes in patients with spontaneous ICH. Methods. Identification of methylation-regulated differentially expressed genes (MeDEGs) between ICH patients and matched controls was performed by analyzing the raw data from the GSE179759 and GSE125512 datasets deposited in the Gene Expression Omnibus. A total of 114 patients who were admitted to our hospital for spontaneous ICH were retrospectively analyzed, with 108 healthy volunteers who had received physical examinations at the same period as controls. The mRNA expression of DOCK1 was determined by quantitative real-time polymerase chain reaction (qRT-PCR). The hematoma volume was calculated according to the Coniglobus formula. The severity of neurological deficits was evaluated using National Institutes of Health Stroke Scale (NIHSS) scores and function outcomes were evaluated by modified Rankin Scale (mRS) scores. Results. A total of 15 MeDEGs between ICH patients and matched controls were identified. The mRNA expression of DOCK1 was remarkably higher in the serum samples of patients with spontaneous ICH than in the healthy controls. According to hematoma volume after ICH attack, small (<10 mL), medium (10 to 30 mL), and large (>30 mL) groups were arranged. The proportions of male patients and patients aged ≥60 years were significantly higher in the large group than in the small and medium groups ( P < 0.05 ). The mRNA expression of DOCK1 was significantly higher in the large group than in the small and medium groups ( P < 0.05 ). According to NIHSS scores, mild (NIHSS scores ≤15), moderate (NIHSS scores from 16 to 30), and severe (NIHSS scores from 31 to 45) groups were classified. It was observed that the severe group had higher proportions of male patients and patients aged ≥60 years than the mild and moderate groups ( P < 0.05 ). The severe group exhibited a higher mRNA expression of DOCK1 than the mild and moderate groups ( P < 0.05 ). According to mRS scores, higher proportions of male patients and patients aged ≥60 years were observed in the unfavorable group than the favorable group ( P < 0.05 ). The patients in the unfavorable group showed an elevated DOCK1 mRNA expression compared to those in the favorable group ( P < 0.05 ). Conclusion. The study provided evidence that male gender, older age, and higher DOCK1 mRNA expression were related to higher admission hematoma volume, neurologic deterioration, and poor function outcomes in patients with spontaneous ICH.

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Section: Discussionmentioning

confidence: 99%

DNA Hypomethylation of DOCK1 Leading to High Expression Correlates with Neurologic Deterioration and Poor Function Outcomes after Spontaneous Intracerebral Hemorrhage

Gao

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…Lobar intracerebral haemorrhage is often caused by cerebral amyloid angiopathy, but hypertension is also an important risk factor. 64 Recent studies reported no statistically significant association between air pollution and haemor rhagic stroke overall. [18][19][20] This finding might suggest that air pollutants exclusively increase intracerebral haemor rhage risk and not subarachnoid haemorrhage.…”

Section: Short-term Exposure To Air Pollution and Risk Of Haemorrhagic Strokementioning

confidence: 98%

Ambient air pollution and the risk of ischaemic and haemorrhagic stroke

Verhoeven

Allach

Vaartjes

et al. 2021

The Lancet Planetary Health

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Stroke is a leading cause of disability and the second most common cause of death worldwide. Increasing evidence suggests that air pollution is an emerging risk factor for stroke. Over the past decades, air pollution levels have continuously increased and are now estimated to be responsible for 14% of all stroke-associated deaths. Interpretation of previous literature is difficult because stroke was usually not distinguished as ischaemic or haemorrhagic, nor by cause. This Review summarises the evidence on the association between air pollution and the different causes of ischaemic stroke and haemorrhagic stroke, to clarify which people are most at risk. The risk for ischaemic stroke is increased after short-term or long-term exposure to air pollution. This effect is most pronounced in people with cardiovascular burden and stroke due to large artery disease or small vessel disease. Short-term exposure to air pollution increases the risk of intracerebral haemorrhage, a subtype of haemorrhagic stroke, whereas the effects of long-term exposure are less clear. Limitations of the current evidence are that studies are prone to misclassification of exposure, often rely on administrative data, and have insufficient clinical detail. In this Review, we provide an outlook on new research opportunities, such as those provided by the decreased levels of air pollution due to the current COVID-19 pandemic.

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“…Impaired vasoregulation due to acute hyperglycemia may enhance perihematomal hypoperfusion in ICH patients, so favouring the development of secondary satellite ischemia brain lesions adding to hemorrhagic damage 48 , 49 . As diabetes mellitus is a specific risk factor for non-lobar ICH 50 , non-diabetic patients with non-lobar ICH might have a higher likelihood of chronical exposure to some degree of unrecognized dysglycemia. Therefore, these patients might also be less vulnerable to the adverse effects of sudden glycemic drops in ischemic perihematomal areas as a consequence of having acquired a higher tolerance to dysglycemia 51 .…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the Finnish study dichotomized hematoma location as infratentorial versus supratentorial, but supratentorial hemorrhages are not at all homogeneous. Lobar ICH is more often associated with amyloid angiopathy whereas non-lobar ICH is more related to diabetes and hypertensive vasculopathy 33 , 50 , 54 . Moreover, although lobar ICH is characterized by a larger admission hematoma volume and worse neurological impairment, its prognosis is usually better than that of non-lobar ICH 33 , 54 .…”

Section: Discussionmentioning

confidence: 99%

Association of early glycemic change with short-term mortality in lobar and non-lobar intracerebral hemorrhage

Forti

Maioli

Zoli

2021

Sci Rep

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The association between early glycemic change and short-term mortality in non-diabetic patients with acute intracerebral hemorrhage (ICH) is unclear. We retrospectively investigated non-diabetic patients with lobar (n = 262) and non-lobar ICH (n = 370). Each patient had a random serum glucose test on hospital admission and a fasting serum glucose test within the following 48 h. Hyperglycemia was defined as serum glucose ≥ 7.8 mmol/l. Four patterns were determined: no hyperglycemia (reference category), persistent hyperglycemia, delayed hyperglycemia, and decreasing hyperglycemia. Associations with 30-day mortality were estimated using Cox models adjusted for major features of ICH severity. Persistent hyperglycemia was associated with 30-day mortality in both lobar (HR 3.00; 95% CI 1.28–7.02) and non-lobar ICH (HR 4.95; 95% CI 2.20–11.09). In lobar ICH, 30-day mortality was also associated with delayed (HR 4.10; 95% CI 1.77–9.49) and decreasing hyperglycemia (HR 2.01, 95% CI 1.09–3.70). These findings were confirmed in Cox models using glycemic change (fasting minus random serum glucose) as a continuous variable. Our study shows that, in non-diabetic patients with ICH, early persistent hyperglycemia is an independent predictor of short-term mortality regardless of hematoma location. Moreover, in non-diabetic patients with lobar ICH, both a positive and a negative glycemic change are associated with short-term mortality.

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Location-specific risk factors for intracerebral hemorrhage

Cited by 48 publications

References 47 publications

DNA Hypomethylation of DOCK1 Leading to High Expression Correlates with Neurologic Deterioration and Poor Function Outcomes after Spontaneous Intracerebral Hemorrhage

DNA Hypomethylation of DOCK1 Leading to High Expression Correlates with Neurologic Deterioration and Poor Function Outcomes after Spontaneous Intracerebral Hemorrhage

Ambient air pollution and the risk of ischaemic and haemorrhagic stroke

Association of early glycemic change with short-term mortality in lobar and non-lobar intracerebral hemorrhage

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