Multidimensional risk network and clinical management of depression after intracerebral hemorrhage

Abstract

Cerebral hemorrhage is a severe hemorrhagic stroke, with an early mortality rate as high as 40%. Post-cerebral hemorrhage depression is a core complication that affects the rehabilitation process of patients, reduces their long-term quality of life and increases the risk of adverse prognosis. Its pathogenesis involves complex interactions in multiple dimensions such as neural structure, inflammatory metabolism and psychosocial aspects. There are still many challenges in clinical identification and intervention. This article systematically reviews the research progress in the field of post-cerebral hemorrhage depression, sorts out its epidemiological characteristics, multi-dimensional risk factors and interaction mechanisms, integrates and proposes a post-cerebral hemorrhage depression risk network framework centered on the three-dimensional interaction of “neural structure damage-inflammatory metabolic disorder-psychosocial stress”, and elaborates the guiding significance of this framework for clinical practice. Finally, in view of the existing research limitations, the key research directions that need to be explored in the future are clarified, providing evidence-based basis and viewpoint references for promoting the precise prevention and control and clinical management optimization of depression after cerebral hemorrhage.

Keywords: Cerebral haemorrhage; Post-stroke depression; Predictive model; Risk stratification; Clinical management

Core Tip: Intracerebral hemorrhage accounts for approximately half of the incidence and mortality of stroke. The early mortality rate can be as high as 40%-50%, approximately twice that of ischemic stroke. Among them, more than one-third of the survivors develop post-stroke depression. This article will conduct an in-depth interpretation and extended exploration of the clinical translational value of this model in promoting mental health management after stroke from the potential neurobiological, inflammatory metabolic, and psychosocial mechanisms behind it. Based on the existing limitations, it is proposed that future research should focus on external validation, mechanism exploration, long-term dynamic prediction, and the development of intervention strategies. Improve the emotional health management level of survivors of acute cerebral hemorrhage.