Secondary injury to distal regions after intracerebral hemorrhage influence neurological functional outcome

Abstract

Although many studies have focused on functional impairment after intracerebral hemorrhage, little is known about the relationship between secondary injuries to distal regions and neurological function. Our study aimed to evaluate the secondary injuries after intracerebral hemorrhage and explore their relationship to neurological functional outcome. Twenty-one patients with hemorrhages in supratentorial, deep locations and 10 healthy subjects were recruited. Longitudinal examinations of diffusion tensor imaging, hydrogen proton magnetic resonance spectroscopy imaging and neuropsychological assessment were performed after weeks 1 and 12 to elucidate the relationship between magnetic resonance imaging parameters and neurologic outcomes. By week 12, motor function had significantly improved, but cognitive function had deteriorated compared to week 1. Fractional anisotropy values for the ipsilateral cerebral peduncle correlated with motor function at week 1. No significant correlation between fractional anisotropy for the ipsilateral cerebral peduncle and the Fugl-Meyer Motor Scale was found at week 12. Fractional anisotropy values for the ipsilateral hippocampus were related to the Montreal Cognitive Assessment and Mini-Mental State Examination at weeks 1 and 12. Deep supratentorial hemorrhage may result in injury to distal regions, which correlate with impaired motor and cognitive function.

Inhibition of PTEN Ameliorates Secondary Hippocampal Injury and Cognitive Deficits after Intracerebral Hemorrhage: Involvement of AKT/FoxO3a/ATG‐Mediated Autophagy

“…Although the hippocampus is not in situ hemorrhagic focus, a secondary injury may cause a decline of memory and cognition ability [5,6]. More recently, a clinical study has shown that ICH patients present a progressive cognitive deficit as early as the 1st week, which is correlated with the fractional anisotropy values for the ipsilateral hippocampus [7]. Furthermore, numerous preclinical studies observed cognition, emotion, and depression-related behavioral deficits in rodent models of ICH [8][9][10].…”

Glymphatic Drainage Blocking Aggravates Brain Edema, Neuroinflammation via Modulating TNF-α, IL-10, and AQP4 After Intracerebral Hemorrhage in Rats

“…This suggests that more work is needed to improve ICH treatment and reduce the risk of death. ICH is associated with toxic metabolites in the hematoncus, which leads to neuronal dysfunction and neurologic impairment (Song et al, 2020). As for the absorption and excretion pathways of these toxic metabolites, the traditional view is that hemosiderin and necrotic brain tissues are mostly engulfed by phagocytes (Chen C. et al, 2020).…”