ABSTRACT
Intracerebral hemorrhage is one of the main causes of death and disability in adults, as a common emergency in neurology department. Hematoma expansion is related to early neurological deterioration and poor outcome in patients with intracerebral hemorrhage. Existing studies have not found effective treatment methods in reducing hematoma expansion. The effective time window of intervention should be paid attention to, and anti-expansion treatments, such as antihypertensive, hemostasis therapy and others, should be performed within the effective time window. The establishment of early emergency green channel for intracerebral hemorrhage is of great significance, to shorten the visiting time of patients with intracerebral hemorrhage and implement effective interventions for anti-hematoma within the anti-hematoma expansion treatment time window.
ABSTRACT
Objective To identify the risk factors of hematoma growth in young patients with intracerebral hemorrhage (1CH). Methods A total of 502 patients with spontaneous intracerebral hemorrhage from the cohort of cerebral small vessel disease of Peking Union Medic&l College Hospital were retrospectively recruited from May 2016 to August 2018. Comparison between cerebral hemorrhage with hematoma growth and non-growth wrre peffamed in the young (76cases,
ABSTRACT
OBJECTIVE: This study was conducted to clarify the association factors and clinical significance of the CT angiography (CTA) spot sign and hematoma growth in Korean patients with acute intracerebral hemorrhage (ICH). METHODS: We retrospectively collected the data of 287 consecutive patients presenting with acute ICH who arrived within 12 hours of ictus. Baseline clinical and radiological characteristics as well as the mortality rate within one month were assessed. A binary logistic regression was conducted to obtain association factors for the CTA spot sign and hematoma growth. RESULTS: We identified a CTA spot sign in 40 patients (13.9%) and hematoma growth in 78 patients (27.2%). An elapsed time to CT scan of less than 3 hours (OR, 5.14; 95% CI, 1.76-15.02; p=0.003) was associated with the spot sign. A CTA spot sign (OR, 5.70; 95% CI, 2.70-12.01; p40 IU (OR, 2.01; 95% CI, 1.01-4.01; p=0.047), and an international normalized ratio > or =1.8 or warfarin medication (OR, 5.64; 95% CI, 1.29-24.57; p=0.021) were independent predictors for hematoma growth. Antiplatelet agent medication (OR, 4.92; 95% CI, 1.31-18.50; p=0.019) was significantly associated with hematoma growth within 6 hours of ictus. CONCLUSION: As previous other populations, CTA spot sign was a strong predictor for hematoma growth especially in hyper-acute stage of ICH in Korea. Antithrombotics medication might also be associated with hyper-acute hematoma growth. In our population, elevated GPT was newly identified as a predictor for hematoma growth and its effect for hematoma growth is necessary to be confirmed through a further research.
Subject(s)
Humans , Alanine Transaminase , Angiography , Cerebral Hemorrhage , Cohort Studies , Hematoma , International Normalized Ratio , Korea , Logistic Models , Mortality , Retrospective Studies , Tomography, X-Ray Computed , WarfarinABSTRACT
Intracerebral hemorrhage is a lethal stroke type with a high morbidity and mortality. Hematoma growth is one of the independent determinants of neurological and functional outcomes after intracerebral hemorrhage. Attenuation of growth is an important therapeutic strategy. Hemostatic therapeutic intervention, given ultra-early in the course of intracerebral hemorrhage, may thus improve clinical outcomes by arresting ongoing bleeding and limiting in turn the size of the hematoma. Recombinant factor VIIa is a hemostatic drug approved to treat bleeding in hemophilia or other coagulopathy; it has also been reported to arrest bleeding in nonhemophilic cases. We reviewed of the published articles specifically addressing clinical trials of recombinant factor VIIa treatment for acute intracerebral hemorrhage and evaluate the safety and feasibility of it.