Perihematomal Edema After Intracerebral Hemorrhage in Patients With Active Malignancy

Gusdon, Aaron M.; Nyquist, Paul; Torres-Lopez, Victor; Leasure, Audrey C; Falcone, Guido J; Sheth, Kevin N; Sansing, Lauren H; Hanley, Daniel F.; Malani, Rachna

doi:10.1161/strokeaha.119.027085

Cited by 8 publications

(16 citation statements)

References 46 publications

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“…17,24 Seven studies (n = 4473 patients) assessed the influence of PHO growth on poor functional outcome. 21,23,25,29,36,41,42 Six out of the seven studies measured aPHO increase while one study assessed increase in OED. 23 There was large variation in the interval between symptom onset, baseline PHO measurement and the timing of the assessment of PHO growth.…”

Section: Resultsmentioning

confidence: 99%

The association between perihaematomal oedema and functional outcome after spontaneous intracerebral haemorrhage: A systematic review and meta-analysis

Cliteur

Sondag

Cunningham

et al. 2023

European Stroke Journal

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Purpose: Perihaematomal oedema (PHO) formation has gained increasing interest as a therapeutic target after spontaneous intracerebral haemorrhage (ICH). Whether PHO contributes to poor outcome is unclear. We aimed to determine the association between PHO and outcome in patients with spontaneous ICH. Method: We searched five databases up to 17 November 2021 for studies of ⩾10 adults with ICH reporting the presence of PHO and outcome. We assessed risk of bias, extracted aggregate data and used random effects meta-analysis to pool studies that reported odds ratios (OR) with 95% confidence intervals (CI). Primary outcome was poor functional outcome defined as modified Rankin Scale score of 3–6 at 3 months. Additionally, we assessed PHO growth and poor outcome at any time of follow-up. We prospectively registered the protocol in PROSPERO (CRD42020157088). Findings: We identified 12,968 articles, of which we included 27 studies ( n = 9534). Eighteen studies reported an association between larger PHO volume and poor outcome, six a neutral result and three an inverse relationship. Larger absolute PHO volume was associated with poor functional outcome at 3 months (OR per mL increase of absolute PHO 1.03, 95% CI 1.00–1.06, I2 44%, four studies). Additionally, PHO growth was associated with poor outcome (OR 1.04, 95% CI 1.02–1.06, I2 0%, seven studies). Discussion: In patients with spontaneous ICH, larger PHO volume is associated with poor functional outcome at 3 months. These findings support the development and investigation of new therapeutic interventions targeting PHO formation to evaluate if reduction of PHO improves outcome after ICH.

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Section: Resultsmentioning

confidence: 99%

The association between perihaematomal oedema and functional outcome after spontaneous intracerebral haemorrhage: A systematic review and meta-analysis

Cliteur

Sondag

Cunningham

et al. 2023

European Stroke Journal

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“…Therefore, a sufficient PC may be needed to prevent recurrence. In contrast, platelets have the potential to facilitate inflammation and may drive the regrowth of CSDH ( 13 , 15 ). In patients with cancer, platelet transfusion was reported to increase perihematomal edema after intracerebral hemorrhage ( 15 ).…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, platelets have the potential to facilitate inflammation and may drive the regrowth of CSDH ( 13 , 15 ). In patients with cancer, platelet transfusion was reported to increase perihematomal edema after intracerebral hemorrhage ( 15 ). Although platelets may have a two-sided effect on the postoperative recurrence of CSDH, the hemostatic effect of platelets may be more closely associated with the recurrence of CSDH, according to our findings.…”

Section: Discussionmentioning

confidence: 99%

Effect of decreased platelets on postoperative recurrence of chronic subdural hematoma

Yagi,

Matsubara,

Kanda

et al. 2023

Front. Neurol.

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IntroductionChronic subdural hematoma (CSDH) is commonly treated using simple burr hole surgery. However, postoperative recurrence occurs at a relatively high rate of 10–20%. A decrease in platelet count (PC) may be associated with recurrence via a hemostasis disorder; however, this association has not been well-studied. Therefore, this study aimed to investigate the association between PC and postoperative CSDH recurrence.MethodsWe retrospectively reviewed the data for CSDHs in 488 cerebral hemispheres of 431 patients who underwent burr hole surgery at our institution between January 2013 and December 2022. The association between preoperative PC and postoperative CSDH recurrence was investigated. We used the first quartile of PC, PC < 170 × 103/μL to define a threshold for decreased PC.ResultsIn total, 459 cerebral hemispheres with CSDHs in 405 patients were followed up postoperatively for at least 3 months or until CSDH disappeared. CSDH recurred in 39 (8.5%) cerebral hemispheres. The recurrence rate was gradually increased in parallel with a decreasing PC. Among 109 CSDHs with a decreased PC (<170 × 103/μL), 15 (13.8%) recurred, whereas only 24 (6.9%) of 350 CSDHs without a decreased PC recurred (p = 0.03). In univariable logistic analysis, eosinophil-rich blood (≥100/μL eosinophils in peripheral blood) and a decreased PC were significant risk factors. Multivariable analysis showed that eosinophil-rich blood (adjusted odds ratio, 2.51; 95% confidence interval, 1.26–4.99; p = 0.009) and a decreased PC (adjusted odds ratio, 2.15; 95% confidence interval, 1.07–4.35; p = 0.03) were independent risk factors for recurrence.ConclusionOur study showed that a decrease in PC was associated with postoperative CSDH recurrence. Patients with CSDH and a decreased PC require careful postoperative follow-up.

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“…9, 2022 hematomal edema. 32) Only seven cases of CEIH in the cerebellum have been reported thus far (Table 1). 4,9,12,14,16,17,20) The duration from initial onset to surgery is approximately 1 month, including the present case; this is a shorter period of time than in cases in other locations.…”

Section: Conflicts Of Interest Disclosurementioning

confidence: 99%

A Case of Bilateral Cerebellar Chronic Encapsulated Intracerebral Hematoma with Rapidly Progressive Symptoms

TOMIOKA

Takahashi

Imai

et al. 2022

NMC Case Report Journal

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Chronic encapsulated intracerebral hematoma (CEIH) is a rare cerebrovascular disease featuring progressively expanding intracranial hematoma. We treated a man in his 70s with bilateral cerebellar CEIH. He had presented at another hospital with dizziness, and imaging showed two independent hemorrhagic space-occupying lesions in the bilateral cerebellar hemispheres. The symptoms progressed relatively rapidly, and there were signs of impending cerebellar herniation; he was transferred to our institution, and emergency surgery was performed. The operative findings included a hematoma with partial capsulation. We diagnosed CEIH from preoperative magnetic resonance imaging and computed tomography findings, clinical course, and pathological findings. The postoperative course was satisfactory. We present this case of bilateral cerebellar CEIH, as an extensive search of the literature suggests that this has not been reported before. Although CEIH is a condition that is usually hard to diagnose preoperatively, good outcomes can be achieved with appropriate surgical treatment. It is therefore important to keep this clinical entity in mind and not miss the right timing to operate.

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Perihematomal Edema After Intracerebral Hemorrhage in Patients With Active Malignancy

Cited by 8 publications

References 46 publications

The association between perihaematomal oedema and functional outcome after spontaneous intracerebral haemorrhage: A systematic review and meta-analysis

The association between perihaematomal oedema and functional outcome after spontaneous intracerebral haemorrhage: A systematic review and meta-analysis

Effect of decreased platelets on postoperative recurrence of chronic subdural hematoma

A Case of Bilateral Cerebellar Chronic Encapsulated Intracerebral Hematoma with Rapidly Progressive Symptoms

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