Simultaneous Multiple Intracerebral Hemorrhages (SMICH)

Wu, Teddy Y; Yassi, Nawaf; Shah, Darshan; Ma, Minmin; Sharma, Gagan; Putaala, Jukka; Strbian, Daniel; Campbell, Bruce C.V.; Yan, Bernard; Tatlısumak, Turgut; Desmond, Patricia; Davis, Stephen M.; Meretoja, Atte

doi:10.1161/strokeaha.116.015186

Cited by 27 publications

(36 citation statements)

References 17 publications

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“…In general, the proposed etiologies of MSICH include not only coagulopathy and anticoagulants but also uncontrolled hypertension, cerebral amyloid angiopathy, cerebral venous sinus thrombosis, multiple cerebral infarctions with hemorrhagic transformation, and vasculitis (12,13). In the present case, the blood pressure was controlled in the normal range.…”

Section: Discussionmentioning

confidence: 46%

Coronavirus Disease 2019 Complicated by Multiple Simultaneous Intracerebral Hemorrhages

et al. 2020

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The relationship between coronavirus disease 2019 (COVID-19) and intracerebral hemorrhage remains unclear. We herein report a case of severe COVID-19 pneumonia complicated by multiple simultaneous intracerebral hemorrhages (MSICH). The patient died eight days after the episode of MSICH. No apparent coagulopathy was observed; however, extracorporeal membrane oxygenation and anticoagulation might have caused the occurrence of MSICH. Laboratory findings showed hypercoagulability, suggesting that thrombotic etiologies, such as sinus thrombosis or cerebral infarction, might also have caused MSICH. MSICH can occur as a fatal complication of COVID-19, and this should be considered when providing treatment.

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Section: Discussionmentioning

confidence: 46%

Coronavirus Disease 2019 Complicated by Multiple Simultaneous Intracerebral Hemorrhages

et al. 2020

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“…Intracerebral hemorrhage represents 8% to 30% of all strokes in the West [1] [2], but 28% to 60% in Africa [3] [4]. Multifocal spontaneous intracerebral hemorrhage is a rare phenomenon [5] [6] and is a separate entity from focal intracerebral hemorrhage. The pathophysiology of spontaneous multifocal intracerebral hemorrhages has not been elucidated [6].…”

Section: Introductionmentioning

confidence: 99%

“…The pathophysiology of spontaneous multifocal intracerebral hemorrhages has not been elucidated [6]. However, several contributing factors have been described in the literature, namely: hypertension, multiple micro-bleeding, by lipohyalinosis, cerebral angiopathy, vasculitis, deep cerebral venous thrombosis, oral anticoagulants, cerebral hemorrhagic infarctions and neoplasm [1] [5] [6] [7]. The multifocal nature of the hemorrhage makes management more difficult and correlates this entity with increased mortality [7] [8].…”

Section: Introductionmentioning

confidence: 99%

“…The factors incriminated at the origin of the development of atrau-These pathological changes are observed mainly in the small perforating arteries which branch out from the major intracerebral pathways with the vessel[8]. According to Weisberg et alCerebral amyloid angiopathy in elderly patients accounts for 5% -20% of recurrent or multifocal intracerebral hemorrhages[5] [11]. It is a risk factor for focal spontaneous intracerebral hemorrhage, which is associated with lobar hematomas.…”

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confidence: 99%

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Multifocal Spontaneous Intracerebral Hemorrhage about a Case and Review of the Literature

Bandzouzı¹,

Mbaki²,

Latou³

et al. 2020

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We describe the case of a spontaneous multifocal intracerebral hemorrhage in a Congolese subject presenting no risk factor. He is a 32-year-old subject with no particular history admitted for seizures in which the cerebral scanner has revealed spontaneous multifocal intracerebral hemorrhages. He only received medical treatment. It remains a very rare entity. The location of the hematoma is variable and is usually located in the basal ganglia due to chronic hypertension.

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“…There is currently no effective acute intervention for ICH, and treatment is mostly supportive. Known predictors for ICH mortality include older age, lower baseline Glasgow Coma Scale (GCS), higher National Institutes of Health Stroke Scale (NIHSS) score, infratentorial location, ICH and intraventricular haemorrhage (IVH) volumes and their growth, oedema, hyperglycaemia, hydrocephalus, herniation, anticoagulation, and multiple haemorrhages [2][3][4][5][6][7]. Higher NIHSS score predicts worse functional outcome [8], and greater functional dependence among ICH survivors has been associated with age, GCS, baseline ICH volume, change of ICH volume at 24 h, and IVH [9].…”

Section: Introductionmentioning

confidence: 99%

Effect of baseline hypocalcaemia on volume of intracerebral haemorrhage in patients presenting within 72 hours from symptom onset

Sallinen

Meretoja

et al. 2019

Journal of the Neurological Sciences

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Introduction: Calcium has a pivotal role in haemostasis. We investigated the association of baseline calcium levels with admission intracerebral haemorrhage (ICH) volume. Methods: This is a retrospective analysis of consecutive ICH patients in an academic hospital between January 2005 and March 2010. Computed tomography (CT) of the brain and serum/plasma ionized calcium had to be taken within 72 h of symptom onset and within 12 h of each other in order to fulfil the study criteria. ICH cases related to trauma or tumour as well as sole intraventricular haemorrhages were excluded. Baseline haematoma volumes were calculated using semiautomated planimetry. The hypocalcaemic (Ca-ion < 1.16 mmol/L) and normocalcaemic (1.16-1.30 mmol/L) patient groups were compared in univariate analyses. Association between admission hypocalcaemia and haematoma volume was studied using multivariable regression models. Results: Out of 1013 consecutive patients, 447 fulfilled the study criteria. Hypocalcaemic patients (n = 178; 39.8%) had larger baseline hematoma volumes (median 30.2 mL, IQR 11.4-58.7 mL), compared to normocalcaemic patients (n = 255; 57.0%; median 16.8 mL, IQR 7.4-44.2 mL). The median ICH volume among hypercalcaemic patients (n = 14; 3.1% of included patients) was 6.5 mL (IQR 3.1-34.6 mL). On linear regression, admission hypocalcaemia was independently associated with larger hematoma volumes (β = 11.77; 95% CI 4.66-18.87, P = 0.01). Patients with larger haematoma volumes had higher mortality. Conclusion: Hypocalcaemia is associated with larger admission haematoma volumes among ICH patients. Higher mortality among hypocalcaemic patients is very likely mediated through larger ICH volumes.

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Simultaneous Multiple Intracerebral Hemorrhages (SMICH)

Cited by 27 publications

References 17 publications

Coronavirus Disease 2019 Complicated by Multiple Simultaneous Intracerebral Hemorrhages

Coronavirus Disease 2019 Complicated by Multiple Simultaneous Intracerebral Hemorrhages

Multifocal Spontaneous Intracerebral Hemorrhage about a Case and Review of the Literature

Effect of baseline hypocalcaemia on volume of intracerebral haemorrhage in patients presenting within 72 hours from symptom onset

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