Time-Dependent Changes in Hematoma Expansion Rate after Supratentorial Intracerebral Hemorrhage and Its Relationship with Neurological Deterioration and Functional Outcome.

hematoma expansion hemorrhagic stroke intracerebral hemorrhage neurological deterioration outcome

Journal

Diagnostics (Basel, Switzerland)
ISSN: 2075-4418
Titre abrégé: Diagnostics (Basel)
Pays: Switzerland
ID NLM: 101658402

Informations de publication

Date de publication:
31 Jan 2024
Historique:
received: 11 01 2024
revised: 29 01 2024
accepted: 30 01 2024
medline: 10 2 2024
pubmed: 10 2 2024
entrez: 10 2 2024
Statut: epublish

Résumé

Hematoma expansion (HE) following an intracerebral hemorrhage (ICH) is a modifiable risk factor and a treatment target. We examined the association of HE with neurological deterioration (ND), functional outcome, and mortality based on the time gap from onset to baseline CT. We included 567 consecutive patients with supratentorial ICH and baseline head CT within 24 h of onset. ND was defined as a ≥4-point increase on the NIH stroke scale (NIHSS) or a ≥2-point drop on the Glasgow coma scale. Poor outcome was defined as a modified Rankin score of 4 to 6 at 3-month follow-up. The rate of HE was higher among those scanned within 3 h (124/304, 40.8%) versus 3 to 24 h post-ICH onset (53/263, 20.2%) ( Despite decreasing rates over time after ICH onset, HE remains an independent predictor of ND, functional outcome, and mortality among those presenting >3 h after onset or with mild symptoms.

Sections du résumé

BACKGROUND BACKGROUND
Hematoma expansion (HE) following an intracerebral hemorrhage (ICH) is a modifiable risk factor and a treatment target. We examined the association of HE with neurological deterioration (ND), functional outcome, and mortality based on the time gap from onset to baseline CT.
METHODS METHODS
We included 567 consecutive patients with supratentorial ICH and baseline head CT within 24 h of onset. ND was defined as a ≥4-point increase on the NIH stroke scale (NIHSS) or a ≥2-point drop on the Glasgow coma scale. Poor outcome was defined as a modified Rankin score of 4 to 6 at 3-month follow-up.
RESULTS RESULTS
The rate of HE was higher among those scanned within 3 h (124/304, 40.8%) versus 3 to 24 h post-ICH onset (53/263, 20.2%) (
CONCLUSION CONCLUSIONS
Despite decreasing rates over time after ICH onset, HE remains an independent predictor of ND, functional outcome, and mortality among those presenting >3 h after onset or with mild symptoms.

Identifiants

pubmed: 38337824
pii: diagnostics14030308
doi: 10.3390/diagnostics14030308
pii:
doi:

Types de publication

Journal Article

Langues

eng

Subventions

Organisme : Doris Duke Charitable Foundation
ID : 2020097
Pays : United States
Organisme : NINDS NIH HHS
ID : K23NS118056
Pays : United States

Auteurs

Gaby Abou Karam (G)

Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520, USA.

Min-Chiun Chen (MC)

Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520, USA.

Dorin Zeevi (D)

Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520, USA.

Bendix C Harms (BC)

Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520, USA.

Victor M Torres-Lopez (VM)

Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA.

Cyprien A Rivier (CA)

Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA.

Ajay Malhotra (A)

Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520, USA.

Adam de Havenon (A)

Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA.
Center for Brain and Mind Health, Yale University School of Medicine, New Haven, CT 06520, USA.

Guido J Falcone (GJ)

Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA.
Center for Brain and Mind Health, Yale University School of Medicine, New Haven, CT 06520, USA.

Kevin N Sheth (KN)

Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA.
Center for Brain and Mind Health, Yale University School of Medicine, New Haven, CT 06520, USA.

Seyedmehdi Payabvash (S)

Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, CT 06520, USA.
Center for Brain and Mind Health, Yale University School of Medicine, New Haven, CT 06520, USA.

Classifications MeSH