Intracerebral hemorrhage natural history: Difference between revisions
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(Created page with "__NOTOC__ {{Intracerebral hemorrhage}} {{CMG}}; {{AE}} {{SaraM}} ==Overview== ==Natural history== ==Complications== ==Prognosis== ==References== {{reflist|2}} Catego...") |
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==Prognosis== | ==Prognosis== | ||
===Prognostic factors=== | |||
====Intracranial hemorrhage==== | |||
*Despite aggressive and newer management strategies, the prognosis of patients with intracerebral hemorrhage is very poor. However, some studies suggested that excellent medical care has a direct impact on [[intracerebral hemorrhage|intracerebral hemorrhage (ICH)]] morbidity and mortality.<ref name="pmid15044768">{{cite journal| author=Hemphill JC, Newman J, Zhao S, Johnston SC| title=Hospital usage of early do-not-resuscitate orders and outcome after intracerebral hemorrhage. | journal=Stroke | year= 2004 | volume= 35 | issue= 5 | pages= 1130-4 | pmid=15044768 | doi=10.1161/01.STR.0000125858.71051.ca | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15044768 }} </ref> | |||
*Case-fatality at 1 month is over 40 % and has not improved in last few decades.<ref name="pmid0056489">{{cite journal| author=Apanasenko BG, Kunitsyn AI, Isaev GA, Khodyrev LP| title=[Determination of the weight of disemulsified lipid circulating in the blood as a method of diagnosis of fat embolism]. | journal=Lab Delo | year= 1976 | volume= | issue= 1 | pages= 41-3 | pmid=0056489 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=56489 }} </ref> | |||
Prognsostic factors in [[Intracerebral hemorrhage]] include:<ref name=Tuhrim> Tuhrim S, Horowitz DR, Sacher M, Godbold JH. Volume of ventricular blood is an important determinant of outcome in supratentorial intracere- bral hemorrhage. Crit Care Med. 1999;27:617–621.</ref> | |||
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! style="background: #4479BA; width: 250px;" | {{fontcolor|#FFF|Poor prognostic factors}} | |||
! style="background: #4479BA; width: 500px;" | {{fontcolor|#FFF|Associations}} | |||
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| style="padding: 5px 5px; background: #DCDCDC;" | '''Fever<ref name="pmid15304576">{{cite journal| author=Leira R, Dávalos A, Silva Y, Gil-Peralta A, Tejada J, Garcia M et al.| title=Early neurologic deterioration in intracerebral hemorrhage: predictors and associated factors. | journal=Neurology | year= 2004 | volume= 63 | issue= 3 | pages= 461-7 | pmid=15304576 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15304576 }} </ref>''' | |||
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*Associated with early neurologic deterioration | |||
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| style="padding: 5px 5px; background: #DCDCDC;" | '''Higher initial blood pressure<ref name="pmid9249937">{{cite journal| author=Sawyer GJ, Fabre JW| title=Indirect T-cell allorecognition and the mechanisms of immunosuppression by allogeneic blood transfusions. | journal=Transpl Int | year= 1997 | volume= 10 | issue= 4 | pages= 276-83 | pmid=9249937 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9249937 }} </ref> ''' | |||
| style="padding: 5px 5px; background: #F5F5F5;" | | |||
*Associated with early neurologic deterioration and increased mortality | |||
|- | |||
| style="padding: 5px 5px; background: #DCDCDC;" | '''Higher creatinine<ref name="pmid17356187">{{cite journal| author=Miller CM, Vespa PM, McArthur DL, Hirt D, Etchepare M| title=Frameless stereotactic aspiration and thrombolysis of deep intracerebral hemorrhage is associated with reduced levels of extracellular cerebral glutamate and unchanged lactate pyruvate ratios. | journal=Neurocrit Care | year= 2007 | volume= 6 | issue= 1 | pages= 22-9 | pmid=17356187 | doi=10.1385/NCC:6:1:22 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17356187 }} </ref>''' | |||
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*[[Hematoma]] expansion | |||
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| style="padding: 5px 5px; background: #DCDCDC;" | '''Higher serum glucose<ref name="pmid9249937">{{cite journal| author=Sawyer GJ, Fabre JW| title=Indirect T-cell allorecognition and the mechanisms of immunosuppression by allogeneic blood transfusions. | journal=Transpl Int | year= 1997 | volume= 10 | issue= 4 | pages= 276-83 | pmid=9249937 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9249937 }} </ref>''' | |||
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*Associated with hematoma expansion and worse outcome | |||
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| style="padding: 5px 5px; background: #DCDCDC;" | '''Warfarin-related hemorrhages<ref name="pmid18703803">{{cite journal| author=Cucchiara B, Messe S, Sansing L, Kasner S, Lyden P, CHANT Investigators| title=Hematoma growth in oral anticoagulant related intracerebral hemorrhage. | journal=Stroke | year= 2008 | volume= 39 | issue= 11 | pages= 2993-6 | pmid=18703803 | doi=10.1161/STROKEAHA.108.520668 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18703803 }} </ref><ref name="pmid17290026">{{cite journal| author=Broderick JP, Diringer MN, Hill MD, Brun NC, Mayer SA, Steiner T et al.| title=Determinants of intracerebral hemorrhage growth: an exploratory analysis. | journal=Stroke | year= 2007 | volume= 38 | issue= 3 | pages= 1072-5 | pmid=17290026 | doi=10.1161/01.STR.0000258078.35316.30 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17290026 }} </ref>''' | |||
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*Associated with an increased [[hematoma|hematoma volume]], greater risk of expansion, and increased morbidity and mortality | |||
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| style="padding: 5px 5px; background: #DCDCDC;" | ''' Warfarin therapy with an [[international normalized ratio|INR]] >3<ref name="pmid18824672">{{cite journal| author=Flaherty ML, Tao H, Haverbusch M, Sekar P, Kleindorfer D, Kissela B et al.| title=Warfarin use leads to larger intracerebral hematomas. | journal=Neurology | year= 2008 | volume= 71 | issue= 14 | pages= 1084-9 | pmid=18824672 | doi=10.1212/01.wnl.0000326895.58992.27 | pmc=2668872 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18824672 }} </ref>''' | |||
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*Associated with larger initial hemorrhage volume as well as poorer outcomes | |||
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| style="padding: 5px 5px; background: #DCDCDC;" | '''[[Intraventricular hemorrhage]]<ref name=Bhattathiri>Bhattathiri PS, Gregson B, Prasad KS, Mendelow AD; STICH Investigators. Intraventricular hemorrhage and hydrocephalus after spon- taneous intracerebral hemorrhage: results from the STICH trial. Acta Neurochir Suppl. 2006;96:65–68.</ref><ref name=Hallevi>Hallevi H, Albright KC, Aronowski J, Barreto AD, Martin-Schild S, Khaja AM, Gonzales NR, Illoh K, Noser EA, Grotta JC. Intraventricular hemorrhage: anatomic relationships and clinical implications. Neurology. 2008;70:848–852. doi: 10.1212/01.wnl.0000304930.47751.75.</ref>''' | |||
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*IVH occurs in approximately 45% of patients with spontaneous ICH and is an independent factor associated with poor outcome | |||
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==References== | ==References== | ||
Revision as of 00:58, 24 November 2016
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Intracerebral hemorrhage Microchapters |
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Treatment |
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AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage (2015) |
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AHA/ASA Guideline Recommendation for the Primary Prevention of Stroke (2014) |
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Intracerebral hemorrhage natural history On the Web |
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American Roentgen Ray Society Images of Intracerebral hemorrhage natural history |
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Risk calculators and risk factors for Intracerebral hemorrhage natural history |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
Natural history
Complications
Prognosis
Prognostic factors
Intracranial hemorrhage
- Despite aggressive and newer management strategies, the prognosis of patients with intracerebral hemorrhage is very poor. However, some studies suggested that excellent medical care has a direct impact on intracerebral hemorrhage (ICH) morbidity and mortality.[1]
- Case-fatality at 1 month is over 40 % and has not improved in last few decades.[2]
Prognsostic factors in Intracerebral hemorrhage include:[3]
| Poor prognostic factors | Associations |
|---|---|
| Fever[4] |
|
| Higher initial blood pressure[5] |
|
| Higher creatinine[6] |
|
| Higher serum glucose[5] |
|
| Warfarin-related hemorrhages[7][8] |
|
| Warfarin therapy with an INR >3[9] |
|
| Intraventricular hemorrhage[10][11] |
|
References
- ↑ Hemphill JC, Newman J, Zhao S, Johnston SC (2004). "Hospital usage of early do-not-resuscitate orders and outcome after intracerebral hemorrhage". Stroke. 35 (5): 1130–4. doi:10.1161/01.STR.0000125858.71051.ca. PMID 15044768.
- ↑ Apanasenko BG, Kunitsyn AI, Isaev GA, Khodyrev LP (1976). "[Determination of the weight of disemulsified lipid circulating in the blood as a method of diagnosis of fat embolism]". Lab Delo (1): 41–3. PMID 0056489.
- ↑ Tuhrim S, Horowitz DR, Sacher M, Godbold JH. Volume of ventricular blood is an important determinant of outcome in supratentorial intracere- bral hemorrhage. Crit Care Med. 1999;27:617–621.
- ↑ Leira R, Dávalos A, Silva Y, Gil-Peralta A, Tejada J, Garcia M; et al. (2004). "Early neurologic deterioration in intracerebral hemorrhage: predictors and associated factors". Neurology. 63 (3): 461–7. PMID 15304576.
- ↑ 5.0 5.1 Sawyer GJ, Fabre JW (1997). "Indirect T-cell allorecognition and the mechanisms of immunosuppression by allogeneic blood transfusions". Transpl Int. 10 (4): 276–83. PMID 9249937.
- ↑ Miller CM, Vespa PM, McArthur DL, Hirt D, Etchepare M (2007). "Frameless stereotactic aspiration and thrombolysis of deep intracerebral hemorrhage is associated with reduced levels of extracellular cerebral glutamate and unchanged lactate pyruvate ratios". Neurocrit Care. 6 (1): 22–9. doi:10.1385/NCC:6:1:22. PMID 17356187.
- ↑ Cucchiara B, Messe S, Sansing L, Kasner S, Lyden P, CHANT Investigators (2008). "Hematoma growth in oral anticoagulant related intracerebral hemorrhage". Stroke. 39 (11): 2993–6. doi:10.1161/STROKEAHA.108.520668. PMID 18703803.
- ↑ Broderick JP, Diringer MN, Hill MD, Brun NC, Mayer SA, Steiner T; et al. (2007). "Determinants of intracerebral hemorrhage growth: an exploratory analysis". Stroke. 38 (3): 1072–5. doi:10.1161/01.STR.0000258078.35316.30. PMID 17290026.
- ↑ Flaherty ML, Tao H, Haverbusch M, Sekar P, Kleindorfer D, Kissela B; et al. (2008). "Warfarin use leads to larger intracerebral hematomas". Neurology. 71 (14): 1084–9. doi:10.1212/01.wnl.0000326895.58992.27. PMC 2668872. PMID 18824672.
- ↑ Bhattathiri PS, Gregson B, Prasad KS, Mendelow AD; STICH Investigators. Intraventricular hemorrhage and hydrocephalus after spon- taneous intracerebral hemorrhage: results from the STICH trial. Acta Neurochir Suppl. 2006;96:65–68.
- ↑ Hallevi H, Albright KC, Aronowski J, Barreto AD, Martin-Schild S, Khaja AM, Gonzales NR, Illoh K, Noser EA, Grotta JC. Intraventricular hemorrhage: anatomic relationships and clinical implications. Neurology. 2008;70:848–852. doi: 10.1212/01.wnl.0000304930.47751.75.