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Intracerebral Hemorrhage

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2. Predicting 30-day mortality in patients with primary intracerebral hemorrhage: Evaluation of the value of intracerebral hemorrhage and modified new intracerebral hemorrhage scores (PubMed)

Predicting 30-day mortality in patients with primary intracerebral hemorrhage: Evaluation of the value of intracerebral hemorrhage and modified new intracerebral hemorrhage scores Background: Different criteria have been proposed to determine the mortality rate of primary intracerebral hemorrhage (ICH). This study aimed to evaluate ICH and Modified New ICH scores in predicting 30-day mortality in patients with primary ICH. Methods: In this prospective cohort study, 107 patients diagnosed

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2018 Iranian journal of neurology

3. Among Patients With Intracerebral Hemorrhage, Is Intensive Blood Pressure Decreasing Associated With Improved Outcome? (SRS therapy)

Among Patients With Intracerebral Hemorrhage, Is Intensive Blood Pressure Decreasing Associated With Improved Outcome? (SRS therapy) TAKE-HOME MESSAGE Intensive blood pressure decreasing in patients with acute intracerebral hemorrhage does not improve functional outcome or mortality. Among Patients With Intracerebral Hemorrhage, Is Intensive Blood Pressure Decreasing Associated With Improved Outcome? EBEM Commentators Zachary T. Brodrick, MD Rachael Freeze-Ramsey, MD Rawle A. Seupaul, MD (...) for intracerebral hemorrhage. Current management focuses on reversal of severe coagulopathy, blood pressure control, and neurosurgical intervention for herniation or ventricular obstruction. 2 Higher blood pressures after intracerebral hemorrhage are associated with increased fatality rates and worse functional outcomes. 3 However, the ideal target blood pressure to optimize clinical METHODS DATA SOURCES The authors performed a search of PubMed, EMBASE, and the Cochrane databases, with the last search conducted

2018 Annals of Emergency Medicine Systematic Review Snapshots

4. Original Intracerebral Hemorrhage Score for the Prediction of Short-Term Mortality in Cerebral Hemorrhage: Systematic Review and Meta-Analysis

Original Intracerebral Hemorrhage Score for the Prediction of Short-Term Mortality in Cerebral Hemorrhage: Systematic Review and Meta-Analysis To systematically assess the discrimination and calibration of the Intracerebral Hemorrhage score for prediction of short-term mortality in intracerebral hemorrhage patients and to study its determinants using heterogeneity analysis.PubMed, ISI Web of Knowledge, Scopus, and CENTRAL from inception to September 15, 2018.Adult studies validating (...) the Intracerebral Hemorrhage score for mortality prediction in nontraumatic intracerebral hemorrhage at 1 month/discharge or sooner.Data were collected on the following aspects of study design: population studied, level of care, timing of outcome measurement, mean study year, and mean cohort Intracerebral Hemorrhage score. The summary measures of interest were discrimination as assessed by the C-statistic and calibration as assessed by the standardized mortality ratio (observed:expected mortality ratio). Random

2019 EvidenceUpdates

5. Blood Pressure Management in Spontaneous Intracerebral Hemorrhage

Blood Pressure Management in Spontaneous Intracerebral Hemorrhage Emergency Medicine > Journal Club > Archive > October 2016 Toggle navigation October 2016 Blood Pressure Management in Spontaneous Intracerebral Hemorrhage Vignette It's a slow Sunday morning in TCC when you get a page that a fifty-year-old patient with a sudden onset of confusion is en route. Per the page, the patient's BP is 210/110, with a heart rate of 85. The patient arrives to the ED awake, alert, but clearly confused. He (...) rechecks the patient's BP, which is now 218/115, and asks what you would like to do to treat this hypertension. You remember learning that when managing BP in intracerebral hemorrhage (ICH) there is a balance between reducing further bleeding and perfusing the rest of the brain, but you aren't sure what the optimal goal BP is or how quickly you should try and achieve this goal. After discussing this with the neurologist, you decide to do a quick literature search and see what the evidence shows... PICO

2017 Washington University Emergency Medicine Journal Club

6. Pre-Intracerebral Hemorrhage and In-Hospital Statin Use in Intracerebral Hemorrhage: A Systematic Review and Meta-analysis.

Pre-Intracerebral Hemorrhage and In-Hospital Statin Use in Intracerebral Hemorrhage: A Systematic Review and Meta-analysis. The association between pre-intracerebral hemorrhage (ICH) statin use and clinical outcomes after intracerebral hemorrhage (ICH) is still conflicting. Recently, some studies investigating the effects of in-hospital statin use after the onset of ICH have been published. To provide a more complete picture of the clinical effects of statin use in ICH, we performed

2018 World neurosurgery

7. Five-Year Risk of Major Ischemic and Hemorrhagic Events After Intracerebral Hemorrhage. (PubMed)

Five-Year Risk of Major Ischemic and Hemorrhagic Events After Intracerebral Hemorrhage. Background and Purpose- We aimed to determine incidences and predictors of major vascular events in intracerebral hemorrhage (ICH) survivors. Methods- We did a prospective observational cohort study in patients with spontaneous ICH from the Prognosis of Intracerebral Hemorrhage cohort in Lille, France. We studied incidences and predictors of long-term vascular events (cerebral and extracerebral, ischemic (...) and hemorrhagic) in patients alive at 30 days with a prespecified subgroup analysis according to ICH location. We performed multivariable analyses (competing risk analyses, with death during follow-up as a competing event). Results- From the 560 patients with spontaneous ICH enrolled between November 2004 and March 2009, we included 310 patients (median age, 70 years). Eighty-two patients presented at least 1 major vascular event leading to an incidence rate of 20.0% (95% CI, 15.7-24.7) at 5 years after ICH

2019 Stroke

8. Subarachnoid and Subdural Hemorrhages in Lobar Intracerebral Hemorrhage Associated With Cerebral Amyloid Angiopathy. (PubMed)

Subarachnoid and Subdural Hemorrhages in Lobar Intracerebral Hemorrhage Associated With Cerebral Amyloid Angiopathy. Background and Purpose- Identifying underlying cerebral amyloid angiopathy (CAA) in patients with intracerebral hemorrhage (ICH) has important clinical implication. Convexity subarachnoid hemorrhage (cSAH) and subdural hemorrhage (SDH) are computed tomography features of CAA-related ICH. We explored whether cSAH and SDH could be additional magnetic resonance imaging markers

2019 Stroke

9. Influence of Intracerebral Hemorrhage Location on Outcomes in Patients With Severe Intraventricular Hemorrhage. (PubMed)

Influence of Intracerebral Hemorrhage Location on Outcomes in Patients With Severe Intraventricular Hemorrhage. Background and Purpose- We investigated the prognostic significance of spontaneous intracerebral hemorrhage location in presence of severe intraventricular hemorrhage. Methods- We analyzed diagnostic computed tomography scans from 467/500 (excluding primary intraventricular hemorrhage) subjects from the CLEAR (Clot Lysis: Evaluating Accelerated Resolution of Intraventricular (...) Hemorrhage) III trial. We measured intracerebral hemorrhage engagement with specific anatomic regions, and estimated association of each region with blinded assessment of dichotomized poor stroke outcomes: mortality, modified Rankin Scale score of 4 to 6, National Institutes of Health Stroke Scale score of >4, stroke impact scale score of <60, Barthel Index <86, and EuroQol visual analogue scale score of <50 and <70 at days 30 and 180, respectively, using logistic regression models. Results- Frequency

2019 Stroke

10. New and expanding ventricular hemorrhage predicts poor outcome in acute intracerebral hemorrhage. (PubMed)

New and expanding ventricular hemorrhage predicts poor outcome in acute intracerebral hemorrhage. To describe the relationship between intraventricular hemorrhage (IVH) expansion and long-term outcome and to use this relationship to select and validate clinically relevant thresholds of IVH expansion in 2 separate intracerebral hemorrhage (ICH) populations.We used fractional polynomial analysis to test linear and nonlinear models of 24-hour IVH volume change and clinical outcome with data from (...) the Predicting Hematoma Growth and Outcome in Intracerebral Hemorrhage Using Contrast Bolus CT (PREDICT)-ICH study. The primary outcome was poor clinical outcome (modified Rankin Scale [mRS] score 4-6) at 90 days. We derived dichotomous thresholds from the selected model and calculated diagnostic accuracy measures. We validated all thresholds in an independent single-center ICH cohort (Massachusetts General Hospital).Of the 256 patients from PREDICT, 127 (49.6%) had an mRS score of 4 to 6. Twenty-four-hour

2019 Neurology

11. Risk of Intracerebral Hemorrhage and Mortality After Convexity Subarachnoid Hemorrhage in Cerebral Amyloid Angiopathy. (PubMed)

Risk of Intracerebral Hemorrhage and Mortality After Convexity Subarachnoid Hemorrhage in Cerebral Amyloid Angiopathy. Background and Purpose- Convexity subarachnoid hemorrhage (cSAH) is an increasingly recognized presentation of cerebral amyloid angiopathy (CAA), usually revealed by transient symptoms, but data on its outcome are limited. We compared the risk of future intracerebral hemorrhage (ICH), cSAH, and death in patients with CAA after cSAH and after lobar ICH. Methods- Consecutive

2019 Stroke

12. Effect of Recombinant Activated Coagulation Factor VII on Hemorrhage Expansion Among Patients With Spot Sign-Positive Acute Intracerebral Hemorrhage: The SPOTLIGHT and STOP-IT Randomized Clinical Trials. (PubMed)

Effect of Recombinant Activated Coagulation Factor VII on Hemorrhage Expansion Among Patients With Spot Sign-Positive Acute Intracerebral Hemorrhage: The SPOTLIGHT and STOP-IT Randomized Clinical Trials. Intracerebral hemorrhage (ICH) is a devastating stroke type that lacks effective treatments. An imaging biomarker of ICH expansion-the computed tomography (CT) angiography spot sign-may identify a subgroup that could benefit from hemostatic therapy.To investigate whether recombinant activated (...) coagulation factor VII (rFVIIa) reduces hemorrhage expansion among patients with spot sign-positive ICH.In parallel investigator-initiated, multicenter, double-blind, placebo-controlled randomized clinical trials in Canada ("Spot Sign" Selection of Intracerebral Hemorrhage to Guide Hemostatic Therapy [SPOTLIGHT]) and the United States (The Spot Sign for Predicting and Treating ICH Growth Study [STOP-IT]) with harmonized protocols and a preplanned individual patient-level pooled analysis, patients

2019 JAMA neurology Controlled trial quality: predicted high

13. Association of APOE ε4 with progressive hemorrhagic injury in patients with traumatic intracerebral hemorrhage. (PubMed)

Association of APOE ε4 with progressive hemorrhagic injury in patients with traumatic intracerebral hemorrhage. The intracranial hematoma volume in patients with traumatic brain injury is a key parameter for the determination of the management approach and outcome. Apolipoprotein E (APOE) ε4 is reported to be a risk factor for larger hematoma volume, which might contribute to a poor outcome. However, whether APOE ε4 is related to progressive hemorrhagic injury (PHI), a common occurrence (...) in the clinical setting, remains unclear. In this study, the authors aimed to investigate the association between the APOE genotype and occurrence of PHI.This prospective study included a cohort of 123 patients with traumatic intracerebral hemorrhage who initially underwent conservative treatment. These patients were assigned to the PHI or non-PHI group according to the follow-up CT scan. A polymerase chain reaction and sequencing method were carried out to determine the APOE genotype. Multivariate logistic

2019 Journal of Neurosurgery

14. Minimally Invasive Surgery for Intracerebral Hemorrhage

Minimally Invasive Surgery for Intracerebral Hemorrhage Background and Purpose- Minimally invasive surgery (MIS) for intracerebral hemorrhage (ICH) has been evaluated in numerous clinical trials. Although meta-analyses for this strategy have been performed in the past, recent trials add important information to results of the comparison and permit strategy-specific analyses, including evaluation of endoscopic evacuation and stereotactic thrombolysis. Methods- Major scientific databases

2019 EvidenceUpdates

15. Antiepileptic Drugs to Prevent Seizures After Spontaneous Intracerebral Hemorrhage

Antiepileptic Drugs to Prevent Seizures After Spontaneous Intracerebral Hemorrhage Background and Purpose- We sought to evaluate the available literature to determine whether primary seizure prevention with antiepileptic drugs reduces the risk of poor outcomes and clinically relevant seizures among adult patients with spontaneous intracerebral hemorrhage. Methods- Meta-analysis of observational studies and randomized controlled trials evaluating the use of any antiepileptic drug for primary (...) seizure prevention among adult (≥18 years) patients with spontaneous intracerebral hemorrhage. The primary end point was poor clinical outcome at the longest recorded follow-up, defined as either a high (>3) modified Rankin Scale score or all-cause mortality during follow-up if the modified Rankin Scale score was not recorded. Early and late seizures were secondary outcomes. A random mixed effects model was used to estimate the pooled odds ratio of outcomes and associated 95% CI. Results- We

2019 EvidenceUpdates

16. Association of Surgical Hematoma Evacuation vs Conservative Treatment With Functional Outcome in Patients With Cerebellar Intracerebral Hemorrhage. (PubMed)

Association of Surgical Hematoma Evacuation vs Conservative Treatment With Functional Outcome in Patients With Cerebellar Intracerebral Hemorrhage. The association of surgical hematoma evacuation with clinical outcomes in patients with cerebellar intracerebral hemorrhage (ICH) has not been established.To determine the association of surgical hematoma evacuation with clinical outcomes in cerebellar ICH.Individual participant data (IPD) meta-analysis of 4 observational ICH studies incorporating

2019 JAMA

17. Does a Spontaneous Intracerebral Hemorrhage Predispose to a Secondary, Distant Intracerebral Hemorrhage? A Case Report and Review of the Literature (PubMed)

Does a Spontaneous Intracerebral Hemorrhage Predispose to a Secondary, Distant Intracerebral Hemorrhage? A Case Report and Review of the Literature Cerebrovascular autoregulation may be dysfunctional after acute intracerebral hemorrhage (ICH). This disruption in autoregulation can potentially result in secondary neurological damage that may present as an intracranial hemorrhage at locations distant from the primary site of hemorrhage. We discuss a case of 68-year-old female who presented (...) with acute left hemiparesis from a spontaneous right frontal ICH. Magnetic resonance imaging (MRI) was negative for any other blooming artifact. Her weakness was improving, but after 72 hours from admission, she had an acute change in her mental status and was found to have a new left frontal ICH distant from the primary hemorrhage. Cerebral dysregulation following spontaneous ICH may predispose patients with risk factors, such as chronic hypertension, to a secondary spontaneous ICH distant from initial

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2017 Cureus

18. Failure of bumetanide to improve outcome after intracerebral hemorrhage in rat. (PubMed)

Failure of bumetanide to improve outcome after intracerebral hemorrhage in rat. After intracerebral hemorrhage (ICH), brain edema commonly occurs and can cause death. Along with edema, there are significant alterations in the concentrations of key ions such as sodium, potassium, and chloride, which are essential to brain function. NKCC1, a cation-chloride cotransporter, is upregulated after brain damage, such as traumatic injury and ischemic stroke. NKCC1 brings sodium and chloride

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2019 PLoS ONE

19. Aggressive blood pressure reduction is not associated with decreased perfusion in leukoaraiosis regions in acute intracerebral hemorrhage patients. (PubMed)

Aggressive blood pressure reduction is not associated with decreased perfusion in leukoaraiosis regions in acute intracerebral hemorrhage patients. Leukoaraiosis regions may be more vulnerable to decreases in cerebral perfusion. We aimed to assess perfusion in leukoaraiosis regions in acute intracerebral hemorrhage (ICH) patients. We tested the hypothesis that aggressive acute BP reduction in ICH patients is associated with hypoperfusion in areas of leukoaraiosis. In the ICH Acutely Decreasing

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2019 PLoS ONE

20. Early increased neutrophil-to-lymphocyte ratio is associated with poor 3-month outcomes in spontaneous intracerebral hemorrhage. (PubMed)

Early increased neutrophil-to-lymphocyte ratio is associated with poor 3-month outcomes in spontaneous intracerebral hemorrhage. The aim of this study was to evaluate the association of dynamic neutrophil-to-lymphocyte ratio (NLR) with 3-month functional outcomes in patients with sICH. We retrospectively identified 213 consecutive patients with sICH hospitalized in The First Affiliated Hospital of Zhengzhou University from January 2017 to May 2018. Patients were divided into functional

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2019 PLoS ONE

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