Edema after intracerebral hemorrhage: correlations with coagulation parameters and treatment

Sansing, Lauren H; Kaznatcheeva, Elena A.; Perkins, Candice J.; Komaroff, Eugene; Gutman, Frederick; Newman, George C.

doi:10.3171/jns.2003.98.5.0985

Cited by 89 publications

(90 citation statements)

References 27 publications

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“…Previous small case series focused on the relationship between perihematomal edema and ICH volumes have shown divergent results, 2-7 but overall, they suggest that perihematomal edema volume could be related to ICH volume at baseline in patients scanned during the first hours from symptom onset. [3][4][5][6][7] Our results support a relationship between perihematomal edema and ICH volumes because both were strongly positively correlated at baseline. …”

Section: Discussionsupporting

confidence: 75%

“…[3][4][5][6][7] Conversely, another study did not find any relationship between perihematomal edema volume and ICH volume or hematoma expansion. 2 Moreover, because of the different timing of hematoma and edema enlargement, the potential relationship between perihematomal edema and ICH volumes at baseline may vary depending on the time from symptom onset to baseline computed tomography (CT) scan.…”

mentioning

confidence: 96%

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Perihematomal Edema Is Greater in the Presence of a Spot Sign but Does Not Predict Intracerebral Hematoma Expansion

Rodríguez‐Luna¹,

Dowlatshahi²,

Kosior³

et al. 2016

Stroke

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Intracerebral hemorrhage (ICH) initiates a secondary injury cascade inducing perihematomal edema development within 3 hours from symptom onset. 1 Perihematomal edema increases over time by ≈100% of absolute volume within the first 24 hours.2 However, the relationship among perihematomal edema, ICH volume, and hematoma expansion has not been well established.Background and Purpose-Perihematomal edema volume may be related to intracerebral hemorrhage (ICH) volume at baseline and, consequently, with hematoma expansion. However, the relationship between perihematomal edema and hematoma expansion has not been well established. We aimed to investigate the relationship among baseline perihematomal edema, the computed tomographic angiography spot sign, hematoma expansion, and clinical outcome in patients with acute ICH. Methods-Predicting Hematoma Growth and Outcome in Intracerebral Hemorrhage Using Contrast Bolus CT (PREDICT) was a prospective observational cohort study of ICH patients presenting within 6 hours from onset. Patients underwent computed tomography and computed tomographic angiography scans at baseline and 24-hour computed tomography scan. A post hoc analysis of absolute perihematomal edema and relative perihematomal edema (absolute perihematomal edema divided by ICH) volumes was performed on baseline computed tomography scans (n=353). Primary outcome was significant hematoma expansion (>6 mL or >33%). Secondary outcomes were early neurological deterioration, 90-day mortality, and poor outcome. Results-Absolute perihematomal edema volume was higher in spot sign patients (24.5 [11.5-41.8

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Section: Discussionsupporting

confidence: 75%

mentioning

confidence: 96%

Perihematomal Edema Is Greater in the Presence of a Spot Sign but Does Not Predict Intracerebral Hematoma Expansion

Rodríguez‐Luna¹,

Dowlatshahi²,

Kosior³

et al. 2016

Stroke

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“…11) Others propose that factors released from activated platelets at the site of hemorrhage, may interact with thrombin to increase vascular permeability and contribute to the development of edema. 15) Brain edema is nearly maximal by 24 hours 19) and most of the growth seems to occur within the first 48 hours of surgery. In that the rate of high GCS group was quite high in patients requiring reoperation, patients in good mental status initially also need to be monitored carefully especially within the first 48 hours after trauma.…”

Section: Discussionmentioning

confidence: 99%

“…The mechanism of injury was divided to seven groups of fall down, slip down, roll down, in-car accident, pedestrian accident, motorcycle accident, and other causes including penetrating injuries. We evaluated the initial GCS of patients, and divided them into three groups of severe (5)(6)(7)(8), moderate (9)(10)(11)(12), and mild (13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Reoperation after Traumatic Intracranial Hemorrhage

Yang

Park

Cho

et al. 2013

Korean J Neurotrauma

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Therefore, early identification and treatment is most important to improve neurological outcome. Though repeated computerized tomography (CT) scans and intracranial pressure (ICP) monitoring and serial neurological examinations are used for early identification, it is also important to identify the predictable risk factors above all.The goals of this study were to identify the risk factors for postoperative progression, and to compare the results with other previous reviews, and to prepare for neurological deterioration effectively. Materials and Methods Patient population and dataA retrospective review of 335 patients who experienced operation after TBI between 2001 and 2010 was performed. Of total 335 patients, we excluded 33 patients having operation due to simple or compound comminuted depressed fractures which were not combined with hematoma showing mass effect or requiring immediate evacuation. We also excluded the case which had been operated in other institute and transferred out to our hospital followed by secondary operation, due to the unavailability of initial data. In addition, we excluded the patients of initial Glasgow Coma Scale (GCS) below 4 or having multiple systemic trauma, due to the difficulty in evaluation of progression and the lack of viability.Among 302 patients except for those cases, 36 patients required reoperation due to hemorrhagic progression fol- Objective: Progression after operation in traumatic brain injury (TBI) is often correlated with morbidity and poor outcome. We have investigated to characterize the natural course of traumatic intracranial hemorrhage and to identify the risk factors for postoperative progression in TBI. Methods: 36 patients requiring reoperation due to hemorrhagic progression following surgery for traumatic intracranial hemorrhage were identified in a retrospective review of 335 patients treated at our hospital between 2001 and 2010. We reviewed the age, sex, Glasgow Coma Scale, the amount of hemorrhage, the type of hemorrhage, rebleeding site, coagulation profiles, and so on. Univariate statistics were used to examine the relationship between the risk factors and reoperation. Results: Acute subdural hematoma was the most common initial lesion requiring reoperation. Most patients had a reoperation within 24-48 hours after operation. Peri-lesional edema (p=0.002), and initial volume of hematoma (p=0.013) were the possible factors of hemorrhagic progression requiring reoperation. But preoperative coagulopathy was not risk factor of hemorrhagic progression requiring reoperation. Conclusion: Peri-lesional edema and initial volume of hematoma were the statistical significant factors requiring reoperation. Close observation with prompt management is needed to improve the outcome even in patient without coagulopathy. (Korean J Neurotrauma 2013;9:114-119) KEY WORDS: Traumatic brain injury ㆍRebleeding ㆍProgression ㆍRisk factor ㆍReoperation.

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“…Πιο συγκεκριμένα, παρα-τηρήθηκε μείωση της διάχυσης του νερού 45min μετά από πειραματική ΚΕΚ, με ακόλουθο εκτεταμένο ενδοκυττάριο οίδημα που παρέμεινε για 2 εβδομάδες μετά την βλάβη [38]. Σε μια άλλη μελέτη βρέθηκε αυξημένος αριθμός αιμοπεταλίων που σχετίστηκε με την ανάπτυξη εκτεταμένου οιδήματος στην περιοχή της αιμορραγίας [39]. Είναι πιθανό η απελευθέρωση του VEGF παράγοντα (vascular endothelial growth factor) από τα ενεργοποιημένα αιμοπετάλια να συμμετέχει στο μηχανισμό σχηματισμού του οιδήματος.…”

Section: εγκεφαλικό οίδημαunclassified

Γενετική Μελέτη Συσχέτισης Πολυμορφισμών Σε Γονίδια Ιντερλευκινών Σε Ασθενείς Με Κρανιοεγκεφαλική Κάκωση

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Edema after intracerebral hemorrhage: correlations with coagulation parameters and treatment

Abstract: The authors propose that factors released from activated platelets at the site of hemorrhage, for example vascular endothelial growth factor, may interact with thrombin to increase vascular permeability and contribute to the development of edema.

Cited by 89 publications

References 27 publications

Perihematomal Edema Is Greater in the Presence of a Spot Sign but Does Not Predict Intracerebral Hematoma Expansion

Perihematomal Edema Is Greater in the Presence of a Spot Sign but Does Not Predict Intracerebral Hematoma Expansion

Risk Factors for Reoperation after Traumatic Intracranial Hemorrhage

Γενετική Μελέτη Συσχέτισης Πολυμορφισμών Σε Γονίδια Ιντερλευκινών Σε Ασθενείς Με Κρανιοεγκεφαλική Κάκωση

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