A dynamic observation of pathologic and ultrastructural changes of perihematoma in intracerebral hemorrhage patients / 中国神经精神疾病杂志

Background In recent years,some researches had been conducted on the pathologic changes of the secondary injury of perihematoma in animal experiments,but only a few studies had been done on the dynamic pathologic and ultrastructural changes of the perihematoma in ICH patients. The unique contribution of our study is to investigate the dynamic pathologic and ultrastructural changes of the perihematoma in ICH patients and provide significant insights into how the pathophysiology and ultrastructures changed after ICH.Methods The written informed consents were obtained from the ICH patients or their relatives. 30 patients (the supertentorial hemotoma volume＞30 mi and the cerebellar hemotoma volume ＞10 mi) were divided into 8 groups according to the time passed after ICH:＜6 h (6 patients), 6 ～ 12 h (7 patients), 12 ～24 h (5 patients), 24～48 h (3 patients), 48 ～72 h (3 patients), 3 ～4 days group (3 patients), 5 days group (2 patients) and 8 days group ( 1 patient) and subjected to craniotomy for hemotoma evacuation. During the operation for the hemotoma's evacuation, a small amount of tissues that must be removed, which located at 1 cm near the hematoma, were taken as experimental groups; And the same tissues of 7 patients (＜12 h), which were far from the hemotoma on the operational way, were taken as control group. The pathologic and ultrastructral changes were observed.Results The tissues of the control group were almost normal while the damages of the tissues from the experimental groups were slight in ＜6 h groups, more severe after 6h and got to the maximum between 24 ～48 h , recovered gradually after 72 h, became similar to the 6 ～ 12 h group on 5 th day, got better on 8 th day and resembled the 6 h group.Conclusions The injury of the perihematoma occurred in early stage, reached the peak level between 24 and 48 hours after ICH; which was consistent to the clinical nervous functional deficits in the ICH patients.

An Analysis of Factors Related to the Shape of Hypertensive Intracerebral Hematoma and Its Clinical Significance

Eighty three cases of hypertensive intracerebral hemorrhage were retrospectively analyzed with a special emphasis on the shape of the hematoma. The hematomas were classified according to the computerized tomography(CT) findings into three groups as circumscribed hematoma with smooth margin and minimal surrounding edema(Type A). circumscribed hematoma with irregular margin and variable surrounding edema(Type B), and highly destructive hematoma with very irregular margin and usually with severe surrounding edema(Type C). The types of the hematoma were unrelated to the patient's age, blood pressure on arrival, serum triglyceride and cholesterol, liver function(except for SGOT), and coagulation study, and location as seen on CT, but were significantly related to the amount of the hematoma. Type A showed relatively better outcome than type B or type C, and type C invariably showed the poorest outcome.

Study on the relationship between complement activation and inflammatory reaction in tissues of the perihematoma in patients with intracerebral hemorrhage / 临床神经病学杂志

72 h goups, respectively. A few tissues distant from the hematoma on the way into the cranium were taken from the 2 former groups as control. Immunohistochemistry staining and reverse transcription polymerase chain reaction (RT-PCR) were used to detected expression of complement facters C3 ,complement inhibitor (Clusterin),the infiltration of the inflammatory cells, the proliferation of neuroglia cells and the expression of cytokins.Results The immunohistochemistry staining showed that the expression of complement facter C3 got to the peak at 12~72 h (P