Acute Management of Hypertension Following Intracerebral Hemorrhage

Haller, J Tyler; Wiss, Adam; May, Casey C.; Jones, G. Morgan; Smetana, Keaton S.

doi:10.1097/cnq.0000000000000247

Cited by 19 publications

(11 citation statements)

References 103 publications

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“…As one of the major life-threatening human pathologies, intracerebral haemorrhage (ICH) is the aetiology underpinning approximately 8–15% of cerebrovascular accidents in the United States each year (Unnithan and Mehta 2021 ). Worldwide epidemiological statistics have indicated that 24.6 individuals per 100,000 experience ICH; these figures are even greater in Asian communities (Weimar and Kleine-Borgman 2017 ; Haller et al 2019 ). The rising incidence of ICH is thus an area of global concern (Sedova et al 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Scalp Acupuncture Protects Against Neuronal Ferroptosis by Activating The p62-Keap1-Nrf2 Pathway in Rat Models of Intracranial Haemorrhage

Dai

et al. 2021

J Mol Neurosci

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Intracerebral haemorrhage (ICH) can be a catastrophic event; even if the initial stages of the pathology were well-managed, a number of patients experience varied residual neurological deficits following the insult. Ferroptosis is a recently identified type of cell demise which is tightly linked to the neurological impairment associated with ICH. In the current work, the prophylactic impact of scalp acupuncture (SA) therapy on autologous blood injection murine models of ICH was investigated in order to establish whether SA could mitigate the secondary damage arising following ICH by moderating ferroptosis. The pathophysiological mechanisms associated with this process were also explored. Ludmila Belayev tests were utilised for the characterisation of neurological damage. Haematoxylin–eosin staining was employed in order to determine the cerebral impact of the induced ICH. Malondialdehyde (MDA) and iron titres in peri-haemorrhagic cerebral tissues were appraised using purchased assay kits. Transmission electron microscopy delineated mitochondrial appearances within nerve cell bodies from the area of haemorrhage. Western blotting techniques were utilised to assay the degree of protein expression of NeuN, sequestosome 1 (p62), nuclear factor erythroid 2-related factor 2 (Nrf2), Kelch-like ECH-associated protein 1 (Keap1), glutathione peroxidase 4 (GPX4) and ferritin heavy chain 1 (FTH1). The frequencies of Nrf2, GPX4 and FTH1 positive cells, respectively, were documented with immunohistochemical staining. The results demonstrated that therapy with SA after ICH mitigated MDA and iron sequestration, diminished the appearance of contracted mitochondria with increased outer mitochondrial membrane diameter within the nerve cell bodies, and suppressed neuronal ferroptosis. The pathways responsible for these effects may encompass amplified p62, Nrf2, GPX4 and FTH1 expression, together with decreased Keap1 expression. Application of SA reduced identified neurobehavioural abnormalities after ICH; no disparities were observed between the consequences of SA therapy and deferoxamine delivery. It can be surmised that intervention with SA enhanced recovery after ICH by triggering the antioxidant pathway, p62/Keap1/Nrf2, and causing FTH1 and GPX4 upregulation, factors that participate in diminishing excess iron and thus in mitigating lipid peroxidation insults arising from ferroptosis following ICH.

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Section: Introductionmentioning

confidence: 99%

Scalp Acupuncture Protects Against Neuronal Ferroptosis by Activating The p62-Keap1-Nrf2 Pathway in Rat Models of Intracranial Haemorrhage

Dai

et al. 2021

J Mol Neurosci

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“…This is, to our knowledge, the first case to report a COVID-19 patient with a complication of cerebral hemorrhage. Hypertension is the most common cause of cerebral hemorrhage [5]. Coagulopathy remains a common cause of cerebral hemorrhage [6].…”

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confidence: 99%

A case of COVID-19 pneumonia with cerebral hemorrhage

Liu

Zhu

et al. 2020

Thrombosis Research

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We agree with Dr. Klok that thromboprophylactic dose low molecular weight heparin should be recommended for all the critically ill patients with 2019 novel coronavirus disease (COVID-19) pneumonia [1]. The very high cumulative incidence of thrombotic complications raises the question if therapeutic anticoagulation should be considered for severe COVID-19 pneumonia patients. As previously reported, patients with COVID-19 may show a wide range of neurologic manifestations, such as loss of consciousness, headache, seizures, ageusia, hyposmia and dysphagia. When clinicians evaluate patients with neurologic symptoms, they should consider SARS-CoV-2 infection as a differential diagnosis [2]. The most commonly described clinical features of COVID-19 have related to overwhelming respiratory symptoms and neurological symptoms have been underestimated and under-reported [3,4]. Recently, Ling Mao and colleagues showed that among 214 COVID-19 patients, 2.8% of them had ischemic stroke [2]. Here we present a case of COVID-19 pneumonia with cerebral hemorrhage. We propose that cerebral hemorrhage, in addition to ischemic stroke, can be a severe neurological manifestation in COVID-19 patients.A 68-year-old male patient with a history of atrial fibrillation on long-term warfarin presented with fever, cough and fatigue for 8 days, associated with shortness of breath for 5 days. He was admitted on Feb 5th, 2020 [illness day 8 (iDay) 8] to Wuhan Red Cross Hospital, a hospital designated to treat patients with severe COVID-19. The patient reported that he had been in contact with confirmed COVID-19 patients. His oropharyngeal swab was tested positive for SARS-CoV-2 by reverse-transcription polymerase-chain-reaction (RT-PCR) assays. No other respiratory viral pathogens were detected. His chest CT showed bilateral multifocal ground-glass opacities, consistent with of COVID-19 pneumonia. The laboratory results indicated elevated INR (1.6), prolonged PT (14.5 s) and normal creatinine (65 μmol/L). He had high levels of both D-dimer (70 mg/L), and C-reactive protein (77.6 mg/L). The patient was diagnosed with severe COVID-19 pneumonia and was admitted to ICU. His oxygen saturation (SpO2) decreased to 80% and he was started with non-invasive mechanical ventilation. He received supportive care; anti-viral treatment including arbidol (0.2 g, tid), lopinavir with ritonavir (LPV/RTV, 400 mg, bid) and recombinant human interferon beta-2b injection (5 million iu, qd); anti-bacterial treatment including moxifloxacin (250 mL, iv drip, qd); and low dose glucocorticoid treatment including methylprednisolone sodium succinate (MPSS, 40 mg, iv drip). Meanwhile, his warfarin was discontinued and he was started with subcutaneously treatment of low molecular weight heparin (LMWH, 4100 iu, qd; nadroparin calcium, AOSIDA, Hebei Changshan Biochemical Pharmaceutical Co., Ltd., 0.4 mL: 4100 iu; his weight 62 kg) for his atrial fibrillation.

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“…The solution-focused approach is an intervention model of clinical central psychotherapy, which has gradually developed into an intervention model in nursing rehabilitation after clinical practice [ 17 – 20 ]. This model respects individuals and improves patients' subjective initiative during rehabilitation by constantly tapping into their own resources and potential.…”

Section: Discussionmentioning

confidence: 99%

Observation on the Effect of Solution-Focused Approach Combined with Family Involvement in WeChat Platform Management on Inpatients with Intracerebral Hemorrhage

Song

2022

Journal of Healthcare Engineering

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Objective. To explore the effect of the solution-focused approach combined with family involvement in the WeChat platform management on inpatients with intracerebral hemorrhage (ICH). Methods. A total of 80 ICH patients hospitalized in our hospital from June 2018 to June 2021 were split into the control group (CG) and the study group (SG) according to the clinical nursing modes, with 40 cases in each group. Both groups received routine intervention, while SG additionally received the solution-focused approach combined with family involvement in the WeChat platform management to compare the self-care ability, psychological status, and hope levels between the two groups after intervention. Results. No significant differences in general data were observed between the two groups ( P > 0.05 ). The SAS and SDS scores before intervention showed mild depression and anxiety in both groups, which improved after intervention. In addition, the SAS and SDS scores after intervention were remarkably lower in SG than in CG ( P < 0.05 ). After intervention, the scores of ICH-related knowledge, self-care skills, self-care responsibility, and rehabilitation knowledge in SG were notably higher compared with CG ( P < 0.05 ). After intervention, the Herth scores of both groups increased, with a higher score in SG than in CG ( P < 0.05 ). After intervention, SG had higher quality of life (QOL) scores in general health, physiological function, physiological role, body pain, vitality, social function, emotional role, and physiological health than CG ( P < 0.05 ). Conclusion. The implementation of the solution-focused approach combined with family involvement in the WeChat platform management for ICH inpatients can effectively improve their psychological status, enhance their self-care ability and hope levels, promote body recovery, and improve their QOL after intervention.

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Acute Management of Hypertension Following Intracerebral Hemorrhage

Cited by 19 publications

References 103 publications

Scalp Acupuncture Protects Against Neuronal Ferroptosis by Activating The p62-Keap1-Nrf2 Pathway in Rat Models of Intracranial Haemorrhage

Scalp Acupuncture Protects Against Neuronal Ferroptosis by Activating The p62-Keap1-Nrf2 Pathway in Rat Models of Intracranial Haemorrhage

A case of COVID-19 pneumonia with cerebral hemorrhage

Observation on the Effect of Solution-Focused Approach Combined with Family Involvement in WeChat Platform Management on Inpatients with Intracerebral Hemorrhage

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