Neurologic deterioration in noncomatose patients with supratentorial intracerebral hemorrhage

Mayer, Stephan A.; Sacco, Ralph L.; Shi, Tianying; Mohr, J. P.

doi:10.1212/wnl.44.8.1379

Cited by 237 publications

(167 citation statements)

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“…A n enlargement of a hematoma (hematoma growth) occurs not uncommonly in patients with spontaneous intracerebral hemorrhage (ICH) after their hospitalization [1][2][3][4][5][6][7][8][9][10][11][12][13] and worsens their clinical outcome. [11][12][13] In our previous review 12 of 419 patients with ICH, we estimated the incidence of hematoma growth (14.3%) and noted the presence of predictors of hematoma growth (viz, a short time interval between admission and onset, an irregularly shaped and large hematoma revealed by an initial CT scan, and liver dysfunction associated with chronic alcohol consumption).…”

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confidence: 99%

“…[11][12][13] In our previous review 12 of 419 patients with ICH, we estimated the incidence of hematoma growth (14.3%) and noted the presence of predictors of hematoma growth (viz, a short time interval between admission and onset, an irregularly shaped and large hematoma revealed by an initial CT scan, and liver dysfunction associated with chronic alcohol consumption). However, in that report we did not examine the interrelationships among those predictors.…”

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confidence: 99%

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Multivariate Analysis of Predictors of Hematoma Enlargement in Spontaneous Intracerebral Hemorrhage

Fujii

Takeuchi

Sasaki

et al. 1998

Stroke

334

271

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Background and Purpose-We conducted this study to determine, through use of multivariate analyses, the independent predictors of hematoma enlargement occurring after hospital admission in patients with spontaneous intracerebral hemorrhage (ICH). Methods-We reviewed 627 patients with ICH admitted within 24 hours of onset. The first CT was performed at admission and the second within 24 hours of admission, and a blood sample was taken for laboratory examinations. Univariate and multivariate analyses were performed to assess the relationships between hematoma enlargement and time from onset, consciousness level, CT findings, amount of alcohol consumption, systolic blood pressure at and after admission, clinical outcome, and hematologic parameters. Hematoma enlargement was an independent factor increasing the mortality rate in the ICH patients (OR, 1.57; PϽ0.001). Conclusions-A particularly high likelihood of hematoma enlargement was observed in patients who (in order of importance) were admitted shortly after onset, who were heavy drinkers; who had an irregularly shaped hematoma, whose consciousness was disturbed, and who had a low level of fibrinogen.

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confidence: 99%

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confidence: 99%

Multivariate Analysis of Predictors of Hematoma Enlargement in Spontaneous Intracerebral Hemorrhage

Fujii

Takeuchi

Sasaki

et al. 1998

Stroke

334

271

View full text Add to dashboard Cite

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“…The secondary pathophysiological processes have been implicated as causes of ongoing, injury including ischemia surrounding the hematoma, the development of cerebral edema [70], activation of apoptotic processes [71], toxic effects of components of the hematoma [72], and intraventricular extension of the primary hemorrhage [73]. The pathogenesis of symptoms and their subsequent recovery are also associated with hematoma size and location.…”

Section: Secondary Processesmentioning

confidence: 99%

“…The edema related to ICH has been cited as a reason for neurological deterioration after the first 24 to 48 h from the onset of symptoms [70], and it has, to a lesser degree, also been implicated with deterioration as late as 3 weeks [65]. The edema has been demonstrated to be predominately vasogenic with a cytotoxic component.…”

Section: Secondary Processesmentioning

confidence: 99%

Treatment Targets in Intracerebral Hemorrhage

Sangha

Gonzales

2011

Neurotherapeutics

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Intracerebral hemorrhage (ICH) imparts a higher mortality and morbidity than ischemic stroke. The therapeutic interventions that are currently available focus mainly on supportive care and secondary prevention. There is a paucity of evidence to support any one acute intervention that improves functional outcome. This chapter highlights current treatment targets for ICH based on the pathophysiology of the disease.

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“…12,38,39 Worsening cerebral oedema has been implicated in neurological deterioration that occurs within 24-48 h after the onset of haemorrhage. 40 Late deterioration can also be associated with progression of oedema during the second and third weeks after the onset. 41 …”

Section: Effects Of Blood Pressure Lowering In Acute Ichmentioning

confidence: 99%

Blood pressure in acute intracerebral haemorrhage

et al. 2004

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Stroke is one of the leading causes of death worldwide, and spontaneous bleeding into the brain parenchyma, intracerebral haemorrhage (ICH), is a stroke subtype associated with high morbidity and mortality. Overall, it comprises about 15% of all stroke in Caucasians, this figure being much higher in Asians and black people. Blood pressure (BP) appears to play an important role in this disease. We have reviewed available literature on the relationship of BP to the occurrence of primary and secondary ICH, the association of BP levels measured early after stroke with prognosis and complications, and evidence about the effects of early BP lowering treatments on post-stroke outcomes. BP appears to be an important risk factor for primary and secondary ICH. In addition, high BP early after ICH may be detrimental to outcome, possibly contributing to complications such as rebleeding and haematoma enlargement. Few data are available about the effects of early lowering of BP on outcome after ICH with no reliable trial yet conducted. Proper randomised trials are required to establish the effect of early lowering of BP on outcome after ICH.

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Neurologic deterioration in noncomatose patients with supratentorial intracerebral hemorrhage

Abstract: ND occurs in one-third of noncomatose patients with supratentorial ICH and carries a poor prognosis. Large hematoma volume on CT, rather than clinical predictors, identifies patients at high risk for subsequent worsening.

Cited by 237 publications

References 0 publications

Multivariate Analysis of Predictors of Hematoma Enlargement in Spontaneous Intracerebral Hemorrhage

Multivariate Analysis of Predictors of Hematoma Enlargement in Spontaneous Intracerebral Hemorrhage

Treatment Targets in Intracerebral Hemorrhage

Blood pressure in acute intracerebral haemorrhage

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