Long-Term Prognosis of Spontaneous Intracerebral Hemorrhage on the Tibetan Plateau: A Prospective Cohort Study at 2 Hospitals

Yuan, Ruozhen; Wang, Deren; Liu, Ming; Liu, Junfeng; He, Yanhu; Deng, Yongyi; Lei, Chunyan; Zeng, Hao; Tao, Wendan; Liu, Bian; Chang, Xueli; Wang, Qiuxiao; Tan, Ge

doi:10.1016/j.wneu.2016.05.064

Cited by 13 publications

(7 citation statements)

References 23 publications

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“…91 A prospective hospital-based study investigated the main cause of intracranial hemorrhage (ICH) and outcomes in Tibetans and found that most of the cases are caused by hypertension and that those patients are at greater risk of disability or disability/death on follow-up compared with patients from the area of Chengdu located at low altitude. 92 A nontraumatic subdural hematoma case has been reported following acute HA exposure. 93 Subarachnoid hemorrhage.…”

Section: Falla Et Al N Nmentioning

confidence: 99%

Recommendations for traveling to altitude with neurological disorders

Falla

Giardini²,

Angelini

2021

J Cent Nerv Syst Dis

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Background Several neurological conditions might worsen with the exposure to high altitude (HA). The aim of this review was to summarize the available knowledge on the neurological HA illnesses and the risk for people with neurological disorders to attend HA locations. Methods A search of literature was conducted for several neurological disorders in PubMed and other databases since 1970. The neurological conditions searched were migraine, different cerebrovascular disease, intracranial space occupying mass, multiple sclerosis, peripheral neuropathies, neuromuscular disorders, epileptic seizures, delirium, dementia, and Parkinson’s disease (PD). Results Attempts were made to classify the risk posed by each condition and to provide recommendations regarding medical evaluation and advice for or against traveling to altitude. Individual cases should be advised after careful examination and risk evaluation performed either in an outpatient mountain medicine service or by a physician with knowledge of HA risks. Preliminary diagnostic methods and anticipation of neurological complications are needed. Conclusions Our recommendations suggest absolute contraindications to HA exposure for the following neurological conditions: (1) Unstable conditions–such as recent strokes, (2) Diabetic neuropathy, (3) Transient ischemic attack in the last month, (4) Brain tumors, and 5. Neuromuscular disorders with a decrease of forced vital capacity >60%. We consider the following relative contraindications where decision has to be made case by case: (1) Epilepsy based on recurrence of seizure and stabilization with the therapy, (2) PD (± obstructive sleep apnea syndrome-OSAS), (3) Mild Cognitive Impairment (± OSAS), and (4) Patent foramen ovale and migraine have to be considered risk factors for acute mountain sickness.

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Section: Falla Et Al N Nmentioning

confidence: 99%

Recommendations for traveling to altitude with neurological disorders

Falla

Giardini²,

Angelini

2021

J Cent Nerv Syst Dis

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“…No other differences in ICH risk factors were detected between the groups with different hemoglobin levels except sex. Previous studies reported a rate of stroke history varying from 2.0 to 9.0% in patients with acute stroke, and a few studies reported the rate of antithrombotic medication use [29][30][31][32]. The mismatch in the stroke history rate and antithrombotic medicine use in the present study may be caused by insufficient stroke rehabilitation system and inadequate realization of secondary prevention of stroke [29][30][31]33].…”

Section: The Characteristics Of Ich Cohortsmentioning

confidence: 52%

“…Blood pressure could have had important effects on the ICH volume in the deep and lobe in the present study, which differed from the expected results, in addition to potential influence of hemoglobin level. A previous study reported that patients with ICH in Tibet were inclined to have higher blood pressure at admission compared with that of other patients [ 30 ]. This parameter may influence deep ICH volume more than lobar ICH volume.…”

Section: Discussionmentioning

confidence: 99%

Impact of Increased Hemoglobin on Spontaneous Intracerebral Hemorrhage

Jin

Zhao

et al. 2021

Neurocrit Care

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Background Studies of the impact of increased hemoglobin on spontaneous intracerebral hemorrhage (ICH) are limited. The present study aimed to explore the effect of increased hemoglobin on ICH. Methods A retrospective single-center study using medical records from a database processed by univariate and multivariate analyses was performed in the People’s Hospital of Tibet Autonomous Region in Lhasa, Tibet, China. Results The mean hemoglobin level in 211 patients with ICH was 165.03 ± 34.12 g/l, and a median hematoma volume was 18.5 ml. Eighty-eight (41.7%) patients had large hematomas (supratentorial hematoma ≥ 30 ml; infratentorial hematoma ≥ 10 ml). No differences in ICH risk factors between the groups with different hemoglobin levels were detected. Increased hemoglobin was independently associated with large hematomas [odds ratio (OR) 1.013, P = 0.023]. Increased hemoglobin was independently associated with ICH with subarachnoid hemorrhage (OR 1.014, P = 0.016), which was more pronounced in men (OR 1.027, P = 0.002). Increased hemoglobin was independently associated with basal ganglia hemorrhage and lobar hemorrhage in men (OR 0.986, P = 0.022; OR 1.013, P = 0.044, respectively) but not in women (P > 0.1). Conclusions Increased hemoglobin was independently associated with large hemorrhage volume. Increased hemoglobin was independently associated with lobar hemorrhage in men and ICH with subarachnoid hemorrhage, which was more pronounced in men. Additional studies are needed to confirm our findings and explore potential mechanisms.

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“…The Glasgow Coma Scale (GCS) score and the National Institutes of Health Stroke Scale (NIHSS) score were evaluated within 24 hours after ICH. The hematoma volume was defined according to the ABC/2 system, 7 and the location of the hemorrhage was named based on the cerebral location of the hematoma. The laboratory values at diagnosis were abstracted by a standardized protocol from the electronic medical record system of the hospital.…”

Section: Methodsmentioning

confidence: 99%

Acute Myocardial Infarction and Concomitant Acute Intracranial Hemorrhage: Clinical Characteristics and Outcomes

Cao

Wang

Tang

et al. 2022

Journal of Investigative Medicine

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This study aimed to evaluate the demographic and clinical characteristics, treatments and outcomes of concomitant acute myocardial infarction (AMI) and acute intracranial hemorrhage (ICH). All patients diagnosed with concomitant AMI and acute ICH admitted to our institution were included retrospectively. The patient demographics, clinical characteristics, neuroimaging and treatment approaches were analyzed, and the outcomes of interest included disability as defined by the modified Rankin Scale (mRS) score and all-cause mortality within 1 year of follow-up. Of a total of 4972 patients with AMI, 8 patients (0.2%) with concomitant acute ICH were recruited for the study, including ST-segment elevation myocardial infarction (STEMI, 5 cases) and non-STEMI (3 cases). New-onset acute ICH in 4 of the 5 patients (80%) occurred within 24 hours after the AMI event, and all these patients had a sudden decrease in the level of consciousness, with an average decrease of 4.6 on the Glasgow Coma Scale. All 5 out of 8 patients had irregular shapes and uncommon sites of hematoma presentation documented on CT scans. Unfortunately, 2 patients died from a progression of ICH within 1 week, and 2 of the 6 survivors had poor functional outcomes (mRS ≥3) at the 1-year follow-up. Concomitant acute ICH and AMI are rare complications displaying unique iconography. Acute ICH caused serious prejudice in AMI with higher mortality and poor functional outcomes, and cardiac catheterization without the administration of antithrombotic or antiplatelet agents was feasible for patients who had unstable hemodynamics or STEMI.

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Long-Term Prognosis of Spontaneous Intracerebral Hemorrhage on the Tibetan Plateau: A Prospective Cohort Study at 2 Hospitals

Cited by 13 publications

References 23 publications

Recommendations for traveling to altitude with neurological disorders

Recommendations for traveling to altitude with neurological disorders

Impact of Increased Hemoglobin on Spontaneous Intracerebral Hemorrhage

Acute Myocardial Infarction and Concomitant Acute Intracranial Hemorrhage: Clinical Characteristics and Outcomes

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