(Stroke. 1997;28:1-5.)
© 1997 American Heart Association, Inc.
Articles |
Early Hemorrhage Growth in Patients With Intracerebral Hemorrhage
the University of Cincinnati (Ohio) Medical Center (T.B., J.B., R.K., T.T., L.S., J.S., J.K.); University of Michigan Medical Center, Ann Arbor (W.B.); and MetroHealth Medical Center, Cleveland, Ohio (J.D.).
Background and Purpose The goal of the present study was to prospectively determine how frequently early growth of intracerebral hemorrhage occurs and whether this early growth is related to early neurological deterioration.
Methods We performed a prospective observational study of patients with intracerebral hemorrhage within 3 hours of onset. Patients had a neurological evaluation and CT scan performed at baseline, 1 hour after baseline, and 20 hours after baseline.
Results Substantial growth in the volume of parenchymal hemorrhage occurred in 26% of the 103 study patients between the baseline and 1-hour CT scans. An additional 12% of patients had substantial growth between the 1- and 20-hour CT scans. Hemorrhage growth between the baseline and 1-hour CT scans was significantly associated with clinical deterioration, as measured by the change between the baseline and 1-hour Glasgow Coma Scale and National Institutes of Health Stroke Scale scores. No baseline clinical or CT prediction of hemorrhage growth was identified.
Conclusions Substantial early hemorrhage growth in patients with intracerebral hemorrhage is common and is associated with neurological deterioration. Randomized treatment trials are needed to determine whether this early natural history of ongoing bleeding and frequent neurological deterioration can be improved.
Key Words: computed tomography • intracerebral hemorrhage • prognosis
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J. P. Broderick, H. P. Adams Jr, W. Barsan, W. Feinberg, E. Feldmann, J. Grotta, C. Kase, D. Krieger, M. Mayberg, B. Tilley, et al. Guidelines for the Management of Spontaneous Intracerebral Hemorrhage : A Statement for Healthcare Professionals From a Special Writing Group of the Stroke Council, American Heart Association Stroke, April 1, 1999; 30(4): 905 - 915. [Full Text] [PDF]
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A. I. Qureshi, D. A. Wilson, D. F. Hanley, and R. J. Traystman No evidence for an ischemic penumbra in massive experimental intracerebral hemorrhage Neurology, January 1, 1999; 52(2): 266 - 266. [Abstract] [Full Text]
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R. T.F. Cheung, Y. Fujii, and R. Tanaka Predictors of Hematoma Growth? • Response Stroke, November 1, 1998; 29(11): 2442 - 2443. [Full Text] [PDF]
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S. A. Mayer, A. Lignelli, M. E. Fink, D. B. Kessler, C. E. Thomas, R. Swarup, and R. L. Van Heertum Perilesional Blood Flow and Edema Formation in Acute Intracerebral Hemorrhage : A SPECT Study Stroke, September 1, 1998; 29(9): 1791 - 1798. [Abstract] [Full Text] [PDF]
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Y. Fujii, S. Takeuchi, O. Sasaki, T. Minakawa, and R. Tanaka Multivariate Analysis of Predictors of Hematoma Enlargement in Spontaneous Intracerebral Hemorrhage Stroke, June 1, 1998; 29(6): 1160 - 1166. [Abstract] [Full Text] [PDF]
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S. Kazui, K. Minematsu, H. Yamamoto, T. Sawada, and T. Yamaguchi Predisposing Factors to Enlargement of Spontaneous Intracerebral Hematoma Stroke, December 1, 1997; 28(12): 2370 - 2375. [Abstract] [Full Text]
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A Systems Approach to Immediate Evaluation and Management of Hyperacute Stroke : Experience at Eight Centers and Implications for Community Practice and Patient Care Stroke, August 1, 1997; 28(8): 1530 - 1540. [Abstract] [Full Text]
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