Progression of hypertensive intracerebral hemorrhage

Chen, S. T.; Chen, S. D.; Hsu, Chung Y.; Hogan, Edward L.

doi:10.1212/wnl.39.11.1509

Cited by 117 publications

(50 citation statements)

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“…4,17) Previous data were analyzed without specific statistical methodol ogy, but some recent reports utilized exact statistical analysis. 2,5,7) ICH enlarged in the acute phase in 26% of cases, and thus is not a rare phenomenon.…”

Section: Discussion I Incidence Of Hematoma Enlargementmentioning

confidence: 99%

Involvement of Fluctuating High Blood Pressure in the Enlargement of Spontaneous Intracerebral Hematoma

Maruishi

Shima

Okada

et al. 2001

Neurol. Med. Chir.(Tokyo)

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The correlations between changes in blood pressure after admission and hematoma expansion were in vestigated in 118 patients with spontaneous intracerebral hematoma admitted within 24 hours of onset who underwent serial computed tomography. Multiple logistic regression was performed to assess cor relations between hematoma enlargement and clinical characteristics on admission. Hematoma en largement was predominantly correlated with time of onset (p 0.01567), and not well correlated with blood pressure at admission (p 0.07908). Serial changes in blood pressure were investigated in 57 patients admitted within 6 hours of ictus whose blood pressures were monitored every hour from admission. Wilcoxon signedrank analysis was used to determine the relationships between hematoma enlargement and blood pressure. Patients with hematoma enlargement was significantly correlated with increased blood pressure (p 0.0004). Increases in blood pressure after admission may be a factor in hematoma enlargement.

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Section: Discussion I Incidence Of Hematoma Enlargementmentioning

confidence: 99%

Involvement of Fluctuating High Blood Pressure in the Enlargement of Spontaneous Intracerebral Hematoma

Maruishi

Shima

Okada

et al. 2001

Neurol. Med. Chir.(Tokyo)

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“…A n enlargement of a hematoma (hematoma growth) occurs not uncommonly in patients with spontaneous intracerebral hemorrhage (ICH) after their hospitalization [1][2][3][4][5][6][7][8][9][10][11][12][13] and worsens their clinical outcome. [11][12][13] In our previous review 12 of 419 patients with ICH, we estimated the incidence of hematoma growth (14.3%) and noted the presence of predictors of hematoma growth (viz, a short time interval between admission and onset, an irregularly shaped and large hematoma revealed by an initial CT scan, and liver dysfunction associated with chronic alcohol consumption).…”

mentioning

confidence: 99%

Multivariate Analysis of Predictors of Hematoma Enlargement in Spontaneous Intracerebral Hemorrhage

Fujii

Takeuchi

Sasaki

et al. 1998

Stroke

341

271

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Background and Purpose-We conducted this study to determine, through use of multivariate analyses, the independent predictors of hematoma enlargement occurring after hospital admission in patients with spontaneous intracerebral hemorrhage (ICH). Methods-We reviewed 627 patients with ICH admitted within 24 hours of onset. The first CT was performed at admission and the second within 24 hours of admission, and a blood sample was taken for laboratory examinations. Univariate and multivariate analyses were performed to assess the relationships between hematoma enlargement and time from onset, consciousness level, CT findings, amount of alcohol consumption, systolic blood pressure at and after admission, clinical outcome, and hematologic parameters. Hematoma enlargement was an independent factor increasing the mortality rate in the ICH patients (OR, 1.57; PϽ0.001). Conclusions-A particularly high likelihood of hematoma enlargement was observed in patients who (in order of importance) were admitted shortly after onset, who were heavy drinkers; who had an irregularly shaped hematoma, whose consciousness was disturbed, and who had a low level of fibrinogen.

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“…Persistent uncontrolled hypertension in acute ICH may increase the risk of ongoing and/or recurrent bleeding from ruptured small arteries and arterioles, leading to haematoma enlargement and clinical deterioration. 36,37 However, the possibility that larger haematomas result in elevated BPs in an attempt to maintain cerebral blood flow in the presence of raised ICP cannot be excluded by these data. A prospective observational study of 103 patients to determine how frequently early growth of ICH occurs failed to identify any significant predictors for haemorrhage growth, including BP.…”

Section: Effects Of Blood Pressure Lowering In Acute Ichmentioning

confidence: 89%

“…34 Based on several relatively small observational studies, it has been suggested that elevated initial BP in ICH is associated with enlargement of haematoma in the period following admission. [35][36][37] Persistent and/or marked elevation of BP has been observed in patients who have been noted to have persistent bleeding or haematoma enlargement on serial CT scans enlargement. Persistent uncontrolled hypertension in acute ICH may increase the risk of ongoing and/or recurrent bleeding from ruptured small arteries and arterioles, leading to haematoma enlargement and clinical deterioration.…”

Section: Effects Of Blood Pressure Lowering In Acute Ichmentioning

confidence: 99%

Blood pressure in acute intracerebral haemorrhage

et al. 2004

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Stroke is one of the leading causes of death worldwide, and spontaneous bleeding into the brain parenchyma, intracerebral haemorrhage (ICH), is a stroke subtype associated with high morbidity and mortality. Overall, it comprises about 15% of all stroke in Caucasians, this figure being much higher in Asians and black people. Blood pressure (BP) appears to play an important role in this disease. We have reviewed available literature on the relationship of BP to the occurrence of primary and secondary ICH, the association of BP levels measured early after stroke with prognosis and complications, and evidence about the effects of early BP lowering treatments on post-stroke outcomes. BP appears to be an important risk factor for primary and secondary ICH. In addition, high BP early after ICH may be detrimental to outcome, possibly contributing to complications such as rebleeding and haematoma enlargement. Few data are available about the effects of early lowering of BP on outcome after ICH with no reliable trial yet conducted. Proper randomised trials are required to establish the effect of early lowering of BP on outcome after ICH.

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Progression of hypertensive intracerebral hemorrhage

Cited by 117 publications

References 0 publications

Involvement of Fluctuating High Blood Pressure in the Enlargement of Spontaneous Intracerebral Hematoma

Involvement of Fluctuating High Blood Pressure in the Enlargement of Spontaneous Intracerebral Hematoma

Multivariate Analysis of Predictors of Hematoma Enlargement in Spontaneous Intracerebral Hemorrhage

Blood pressure in acute intracerebral haemorrhage

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