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For: Koivunen RJ, Satopää J, Meretoja A, Strbian D, Haapaniemi E, Niemelä M, Tatlisumak T, Putaala J. Incidence, risk factors, etiology, severity and short-term outcome of non-traumatic intracerebral hemorrhage in young adults. Eur J Neurol 2014;22:123-32. [PMID: 25142530 DOI: 10.1111/ene.12543] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 06/23/2014] [Indexed: 11/28/2022]

For:	Koivunen RJ, Satopää J, Meretoja A, Strbian D, Haapaniemi E, Niemelä M, Tatlisumak T, Putaala J. Incidence, risk factors, etiology, severity and short-term outcome of non-traumatic intracerebral hemorrhage in young adults. Eur J Neurol 2014;22:123-32. [PMID: 25142530 DOI: 10.1111/ene.12543] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Accepted: 06/23/2014] [Indexed: 11/28/2022]

Number

Cited by Other Article(s)

Tsimpiris A, Tsolianos I, Grigoriadis A, Tsimtsiou Z, Goulis DG, Grigoriadis N. Association of Chronic Periodontitis with Hemorrhagic Stroke: A Systematic Review and Meta-Analysis. Eur J Dent 2025;19:265-274. [PMID: 39657943 PMCID: PMC12020598 DOI: 10.1055/s-0044-1793844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2024] Open

Abstract

Periodontitis is a chronic, multifactorial inflammatory condition linked to dysbiotic plaque biofilms and characterized by the gradual destruction of the structures supporting the teeth owing to compromised immune system function. Hemorrhagic stroke, which primarily occurs within the brain tissue or in the subarachnoid space as a blood leak of ruptured vessels, is a sudden neurological impairment caused by vascular damage in the central nervous system, resulting in focal neurological deficits. Chronic periodontitis (CP) and hemorrhagic stroke may share common pathogenic features involving inflammation and immune system activation, prompting researchers to investigate their potential connection. The aim of the study is to systematically review the literature on the epidemiological association between CP and hemorrhagic stroke in adults. The study protocol adhered to the PRISMA 2020 guidelines, and the design followed the Cochrane methodology. A thorough literature search encompassing PubMed, Scopus, and Web of Science databases and a manual search and evaluation of gray literature was conducted. Meta-analysis was performed using Review Manager (RevMan) 5.4, with the effect size represented by the odds ratio (OR) and a 95% confidence interval (CI). Heterogeneity was assessed using the chi-squared and I 2 statistics. The selected articles, written in English without time constraints, focused on observational studies involving patients and controls and included disease diagnostic criteria. Duplicate entries were eliminated. The reliability of each study's results was evaluated using the Newcastle-Ottawa Scale and GRADE tools. Two reviewers conducted the assessments, and a third reviewer resolved any disagreements. The meta-analysis comprised four observational studies involving 1,882 individuals. It revealed that individuals diagnosed with hemorrhagic stroke were notably more likely to have concurrent CP (OR: 6.32; 95% CI: 1.35-29.49; p = 0.02) or severe CP (OR: 3.08; 95% CI: 1.56-6.06; p = 0.001) compared with healthy controls. A notable occurrence of CP was detected in patients with hemorrhagic stroke compared with controls. Health care professionals need to acknowledge the connection between the two conditions, as it allows them to provide optimal holistic care through a thorough approach to diagnosis and treatment.

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Wang H, Lin J, Wang L, Zhang X, Zhou T, Zhang C, Zhang S, Hu R. Global, Regional, and National Burden of Intracerebral Hemorrhage in Young Adults From 1990 to 2021: A Population-Based Study. J Am Heart Assoc 2024;13:e037286. [PMID: 39450741 PMCID: PMC11935651 DOI: 10.1161/jaha.124.037286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 09/16/2024] [Indexed: 10/26/2024]

Lekoubou A, Cohrs A, Dejuk M, Hong J, Sen S, Bonilha L, Chinchilli VM. Acute seizures after spontaneous intracerebral hemorrhage in young individuals: 11-year trends and association with mortality. Epilepsy Res 2024;205:107408. [PMID: 39002389 DOI: 10.1016/j.eplepsyres.2024.107408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/27/2024] [Accepted: 07/01/2024] [Indexed: 07/15/2024]

Abstract

BACKGROUND

The rate of spontaneous Intracerebral Hemorrhage (sICH) is rising among young Americans. Trends in acute seizure (AS) incidence in this age group is largely unknown. Further, the association of AS with mortality has not been reported in this age group. The aim of this study is to determine trends in AS among young individuals with sICH.

METHODS

The Merative MarketScan® Commercial Claims and Encounters database, for the years 2005 through 2015, served as the data source for this retrospective in-hospital population study. This period was chosen as spontaneous ICH incidence increased among young individuals between 2005 and 2015. Our study population included patients aged 18-64 years with ICH identified using the International Classification of Diseases, Ninth and Tenth Revision (ICD-9/10) codes 430, 431, 432.0, 432.1, 432.9, I61, I61.0, I61.1, I61.2, I61.3, I61.4, I61.5, I61.6, I61.8, and I61.9, excluding those with a prior diagnosis of seizures (ICD-9/10 codes 345.x,780.3x, G40, G41, and R56.8). We computed yearly AS incidence, mortality (in patients with and without seizures), and analyzed trends. We applied a logistic regression model to determine the independent association of AS with mortality accounting for demographic and clinical variables.

RESULTS

AS incidence increased linearly between 2005 (incidence rate: 8.1 %) and 2015 (incidence rate: 11.0 %), which represents a 26 % relative increase (P for trends <0.0001). In-hospital mortality rate was 14.3 % among those who developed AS and 11.5 % among those who did not have AS. Overall, between 2005 and 2015, in-hospital mortality decreased from 13.0 % to 9.7 % among patients without AS but remained unchanged among those with AS. Patients who developed AS were 10 % more likely to die than those who did not (OR: 1.10, 95 % confidence interval: 1.02-1.18).

CONCLUSIONS

Between 2005 and 2015, the incidence of AS increased by nearly 26 % among young Americans with sICH. In-patient mortality remained unchanged among those who developed seizures but declined among those who did not. The occurrence of AS was independently associated with a 10 % higher risk of in-hospital death.

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Łopatka P, Błaż M, Nowicki G, Undas A. Altered fibrin clot phenotype in young adults with intracerebral hemorrhage of unknown cause: A case-control study. Thromb Res 2024;240:109062. [PMID: 38901058 DOI: 10.1016/j.thromres.2024.109062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 05/13/2024] [Accepted: 06/05/2024] [Indexed: 06/22/2024]

Verho L, Aarnio K, Tikkanen M, Äyräs O, Rantanen K, Korhonen A, Richardt A, Laivuori H, Gissler M, Ijäs P. Long-Term Mortality, Recovery, and Vocational Status After a Maternal Stroke: Register-Based Observational Case-Control Study. Neurology 2024;103:e209532. [PMID: 38870454 DOI: 10.1212/wnl.0000000000209532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024] Open

Abstract

BACKGROUND AND OBJECTIVES

Maternal stroke is a rare event with an increasing incidence. Data on the long-term prognosis after a maternal stroke are limited. We aimed to examine long-term mortality, recovery, vocational status and morbidity after a maternal stroke in a population-based setting including a comparison with matched, stroke-free controls.

METHODS

In this register-based study with hospital chart validation, we included all women with a maternal stroke in Finland in 1987-2016 who survived the first year after the event. The recovery of the cases was assessed from the hospital charts by modified Rankin scale (mRS). Three controls matched by delivery year, age, and parity were selected for each case. All deaths until 2022 were identified from the Register for Causes of Death. Data on vocational status were obtained from Statistics Finland and morbidity from the Hospital Discharge Register and patient charts until year 2016.

RESULTS

The study included 235 women with a maternal stroke and 694 matched controls. The median follow-up time was 17.5 years (interquartile range [IQR] 9.6-25.4) for mortality and 11.8 years (IQR 3.8-19.8) for vocational status and subsequent morbidity. Mortality among cases was 5.5% and among controls, 2.4% (age-adjusted odds ratio [OR] 2.3, 95% [CI] 1.1-4.9). At the end of the follow-up, 90.3% of the cases were independent in daily activities (mRS ≤2). In 2016, fewer women with a maternal stroke were working compared with controls (65.9% vs 79.1%, OR 0.5, 95% CI 0.4-0.7) and were more often receiving a pension (18.2% vs 4.9%, OR 4.4, 95% CI 2.7-7.3). Cerebrovascular events (age-adjusted OR 8.6 95% CI 4.4-17.1), cardiac diseases (age-adjusted OR 3.3, 95% CI 1.4-7.7), and major cardiovascular events were more common among cases during the follow-up (age-adjusted OR 7.6 95% CI 3.1-18.7).

DISCUSSION

Despite having higher overall mortality and higher cardiovascular morbidity, the majority of the maternal stroke survivors recovered well. As expected, the vocational status of cases was inferior to that of controls, but most women were working at the end of the follow-up. Our study provides important information on the prognosis and sequalae after a maternal stroke to help in patient counseling and to improve secondary prevention.

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Affiliation(s)

Liisa Verho From the Department of Neurology (L.V., K.A., K.R., A.K., A.R., P.I.); Department of Obstetrics and Gynecology (L.V., O.Ä.), University of Helsinki and Helsinki University Hospital; Department of Obstetrics and Gynecology (M.T.), University of Helsinki; Medical and Clinical Genetics (H.L.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (H.L.), Helsinki Institute of Life Science, University of Helsinki; Department of Obstetrics and Gynecology (H.L.), Tampere University Hospital and Tampere University, Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research; Department of Knowledge Brokers (M.G.), Finnish Institute for Health and Welfare, Finland; and Region Stockholm (M.G.), Academic Primary Health Care Centre, Stockholm, Sweden and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Karoliina Aarnio From the Department of Neurology (L.V., K.A., K.R., A.K., A.R., P.I.); Department of Obstetrics and Gynecology (L.V., O.Ä.), University of Helsinki and Helsinki University Hospital; Department of Obstetrics and Gynecology (M.T.), University of Helsinki; Medical and Clinical Genetics (H.L.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (H.L.), Helsinki Institute of Life Science, University of Helsinki; Department of Obstetrics and Gynecology (H.L.), Tampere University Hospital and Tampere University, Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research; Department of Knowledge Brokers (M.G.), Finnish Institute for Health and Welfare, Finland; and Region Stockholm (M.G.), Academic Primary Health Care Centre, Stockholm, Sweden and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Minna Tikkanen From the Department of Neurology (L.V., K.A., K.R., A.K., A.R., P.I.); Department of Obstetrics and Gynecology (L.V., O.Ä.), University of Helsinki and Helsinki University Hospital; Department of Obstetrics and Gynecology (M.T.), University of Helsinki; Medical and Clinical Genetics (H.L.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (H.L.), Helsinki Institute of Life Science, University of Helsinki; Department of Obstetrics and Gynecology (H.L.), Tampere University Hospital and Tampere University, Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research; Department of Knowledge Brokers (M.G.), Finnish Institute for Health and Welfare, Finland; and Region Stockholm (M.G.), Academic Primary Health Care Centre, Stockholm, Sweden and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Outi Äyräs From the Department of Neurology (L.V., K.A., K.R., A.K., A.R., P.I.); Department of Obstetrics and Gynecology (L.V., O.Ä.), University of Helsinki and Helsinki University Hospital; Department of Obstetrics and Gynecology (M.T.), University of Helsinki; Medical and Clinical Genetics (H.L.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (H.L.), Helsinki Institute of Life Science, University of Helsinki; Department of Obstetrics and Gynecology (H.L.), Tampere University Hospital and Tampere University, Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research; Department of Knowledge Brokers (M.G.), Finnish Institute for Health and Welfare, Finland; and Region Stockholm (M.G.), Academic Primary Health Care Centre, Stockholm, Sweden and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Kirsi Rantanen From the Department of Neurology (L.V., K.A., K.R., A.K., A.R., P.I.); Department of Obstetrics and Gynecology (L.V., O.Ä.), University of Helsinki and Helsinki University Hospital; Department of Obstetrics and Gynecology (M.T.), University of Helsinki; Medical and Clinical Genetics (H.L.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (H.L.), Helsinki Institute of Life Science, University of Helsinki; Department of Obstetrics and Gynecology (H.L.), Tampere University Hospital and Tampere University, Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research; Department of Knowledge Brokers (M.G.), Finnish Institute for Health and Welfare, Finland; and Region Stockholm (M.G.), Academic Primary Health Care Centre, Stockholm, Sweden and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Aino Korhonen From the Department of Neurology (L.V., K.A., K.R., A.K., A.R., P.I.); Department of Obstetrics and Gynecology (L.V., O.Ä.), University of Helsinki and Helsinki University Hospital; Department of Obstetrics and Gynecology (M.T.), University of Helsinki; Medical and Clinical Genetics (H.L.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (H.L.), Helsinki Institute of Life Science, University of Helsinki; Department of Obstetrics and Gynecology (H.L.), Tampere University Hospital and Tampere University, Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research; Department of Knowledge Brokers (M.G.), Finnish Institute for Health and Welfare, Finland; and Region Stockholm (M.G.), Academic Primary Health Care Centre, Stockholm, Sweden and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Anna Richardt From the Department of Neurology (L.V., K.A., K.R., A.K., A.R., P.I.); Department of Obstetrics and Gynecology (L.V., O.Ä.), University of Helsinki and Helsinki University Hospital; Department of Obstetrics and Gynecology (M.T.), University of Helsinki; Medical and Clinical Genetics (H.L.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (H.L.), Helsinki Institute of Life Science, University of Helsinki; Department of Obstetrics and Gynecology (H.L.), Tampere University Hospital and Tampere University, Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research; Department of Knowledge Brokers (M.G.), Finnish Institute for Health and Welfare, Finland; and Region Stockholm (M.G.), Academic Primary Health Care Centre, Stockholm, Sweden and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Hannele Laivuori From the Department of Neurology (L.V., K.A., K.R., A.K., A.R., P.I.); Department of Obstetrics and Gynecology (L.V., O.Ä.), University of Helsinki and Helsinki University Hospital; Department of Obstetrics and Gynecology (M.T.), University of Helsinki; Medical and Clinical Genetics (H.L.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (H.L.), Helsinki Institute of Life Science, University of Helsinki; Department of Obstetrics and Gynecology (H.L.), Tampere University Hospital and Tampere University, Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research; Department of Knowledge Brokers (M.G.), Finnish Institute for Health and Welfare, Finland; and Region Stockholm (M.G.), Academic Primary Health Care Centre, Stockholm, Sweden and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Mika Gissler From the Department of Neurology (L.V., K.A., K.R., A.K., A.R., P.I.); Department of Obstetrics and Gynecology (L.V., O.Ä.), University of Helsinki and Helsinki University Hospital; Department of Obstetrics and Gynecology (M.T.), University of Helsinki; Medical and Clinical Genetics (H.L.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (H.L.), Helsinki Institute of Life Science, University of Helsinki; Department of Obstetrics and Gynecology (H.L.), Tampere University Hospital and Tampere University, Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research; Department of Knowledge Brokers (M.G.), Finnish Institute for Health and Welfare, Finland; and Region Stockholm (M.G.), Academic Primary Health Care Centre, Stockholm, Sweden and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
Petra Ijäs From the Department of Neurology (L.V., K.A., K.R., A.K., A.R., P.I.); Department of Obstetrics and Gynecology (L.V., O.Ä.), University of Helsinki and Helsinki University Hospital; Department of Obstetrics and Gynecology (M.T.), University of Helsinki; Medical and Clinical Genetics (H.L.), University of Helsinki and Helsinki University Hospital; Institute for Molecular Medicine Finland (H.L.), Helsinki Institute of Life Science, University of Helsinki; Department of Obstetrics and Gynecology (H.L.), Tampere University Hospital and Tampere University, Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research; Department of Knowledge Brokers (M.G.), Finnish Institute for Health and Welfare, Finland; and Region Stockholm (M.G.), Academic Primary Health Care Centre, Stockholm, Sweden and Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden

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Hassan MS, Bakir A, Sidow NO, Erkok U, Ahmed SA, Abshir MD, Köksal AA. Etiology, Risk Factors and Outcome of Spontaneous Intracerebral Hemorrhage in Young Adults Admitted to Tertiary Care Hospital in Mogadishu, Somalia. Int J Gen Med 2024;17:2865-2875. [PMID: 38947564 PMCID: PMC11214575 DOI: 10.2147/ijgm.s470314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 06/20/2024] [Indexed: 07/02/2024] Open

Abstract

Introduction

Spontaneous Intracerebral hemorrhage (ICH) in young patients is less common and not well studied compared to ICH in older patients. The etiology, risk factors and outcome of ICH in young patients may have regional and ethnic differences. The study aims to investigate the clinical characteristics, risk factors, etiology and outcome of spontaneous intracerebral hemorrhage in young adults in Somalia.

Methods

The study enrolled 168 young patients with ICH (16-50 years) admitted to the neurology department of a tertiary hospital from 2019 to 2022. The information about the demographic details, documented ICH risk factors, etiology and patients' clinical status were retrieved. The etiology of ICH was determined based on clinical, laboratory and radiological findings. Intra-hospital survival status and associated factors were assessed.

Results

The mean age of the patients was 35±8.6 years. 99 (59%) of patients were male while 69 (41%) were females. Hypertension 48 (29%) was the most common risk factor, followed by substance abuse. Hypertensive hemorrhage was the most common etiology of ICH 60 (35.7%), followed by cerebral venous thrombosis (CVT) 5(15%), substance abuse 23 (13.7%) and arteriovenous malformation (AVM) in 10 (6%). AVM, CVT, cavernoma, eclampsia, substance abuse and cryptogenic etiology were more common in the 2nd and 3rd decades whereas hypertension was more common in the 4th and 5th decade. Intrahospital mortality was 28% in this study. Factors predicting intrahospital mortality were hematoma volume of greater than 30mL, thrombolytic etiology, brainstem ICH location, substance abuse related etiology, presence of associated mass effect, low GCS score on admission, high systolic blood pressure on admission, and the presence of chronic renal failure.

Conclusion

In this study, hypertension, substance abuse, CVT and vascular malformation are the leading causes of ICH in young adults. Intracerebral hemorrhage in the young has different spectrum of etiologies and factors associated with short-term mortality compared to older patients.

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Huang B, Chen A, Sun Y, He Q. The Role of Aging in Intracerebral Hemorrhage. Brain Sci 2024;14:613. [PMID: 38928613 PMCID: PMC11201415 DOI: 10.3390/brainsci14060613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/10/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024] Open

Li X, Xiao Z, Li P, Yang W, Shen Y, Liu F, Xiong X, Wu Q, Wang P, Dang R, Gui S, Deng L, Manaenko A, Xie P, Li Q. Age-related changes after intracerebral hemorrhage: a comparative proteomics analysis of perihematomal tissue. Exp Biol Med (Maywood) 2024;249:10117. [PMID: 38590360 PMCID: PMC11001198 DOI: 10.3389/ebm.2024.10117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/23/2024] [Indexed: 04/10/2024] Open

Affiliation(s)

Xinhui Li Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Zhongsong Xiao Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Peizheng Li Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Wensong Yang Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Yiqing Shen Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Fangyu Liu Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Xin Xiong Department of Neurology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China
Qingyuan Wu NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China Department of Neurology, Chongqing University Three Gorges Hospital, Chongqing, China
Peng Wang Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Ruozhi Dang Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Siwen Gui Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Lan Deng Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Anatol Manaenko Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Peng Xie Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
Qi Li Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China

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Tian Y, Zhang Y, He J, Hao P, Li T, Xiao Y, Peng L, Feng Y, Cheng X, Deng H, Wang P, Chong W, Hai Y, Chen L, You C, Fang F. Association of anemia with mortality in young adult patients with intracerebral hemorrhage. Sci Rep 2023;13:19711. [PMID: 37953289 PMCID: PMC10641070 DOI: 10.1038/s41598-023-46941-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 11/07/2023] [Indexed: 11/14/2023] Open

Chen C, Xie Y, Pu M, Deng L, Li Z, Yang T, Yin H, Zhang Z, Lv X, Liu X, Cheng J, Li Q. Age-related differences in risk factors, clinical characteristics, and outcomes for intracerebral hemorrhage. Front Aging Neurosci 2023;15:1264124. [PMID: 38020784 PMCID: PMC10655109 DOI: 10.3389/fnagi.2023.1264124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open

Abstract

Background and purpose

Intracerebral hemorrhage (ICH) is a severe form of stroke that remains understudied in the young adults. We aimed to investigate the clinical presentation, and risk factors associated with ICH in this age group and compare them to older patients.

Methods

Our study included ICH patients admitted between March 2016 and December 2021 in the First Affiliated Hospital of Chongqing Medical University from our ongoing prospective cohort database. Demographic characteristics, etiology, risk factors, and clinical outcomes were compared between elderly and young patients. Furthermore, logistic regression analysis was employed to explore risk factors associated with the functional outcome at 3-months.

Results

We selected 1,003 patients (mean age, 59.9 ±13.8 years old), 746 (74.4%) patients were aged >50 years. The logistic regression analysis showed young patients have a higher proportion of secondary ICH, higher white blood cell count and higher body mass index (BMI), but less diabetes mellitus. Of all patients, predictors of 3-month functional independence was first-ever ICH and age ≤50 years. The history of nephropathy and stroke, higher baseline NIHSS score, larger hematoma volume, and the presence of hydrocephalus were associated with poor outcomes. And the white blood cell count could significantly influence the prognosis among young ICH patients. Three-month functional outcome based on modified Rankin scale score was better in young patients than the elderly (OR, 1.232; 95% CI, 1.095-1.388; p < 0.001).

Conclusions

The highest incidence of ICH occurs in the age groups of 50-59 and 60-69. ICH in young adults had higher white blood cell and BMI compared to the elderly, and differs in etiological distribution. The young patients also had similar short-term mortality but more favorable functional outcomes than the elderly. Furthermore, NIHSS score and larger hematoma volumes were associated with poor outcome in all patients.

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Bankole NDA, Adjiou DKFDP, Moune MY, Hemama M, El Fatemi N, El Maaqili MR. Spontaneous intraparenchymal hemorrhage in young adults: Cross-sectional study. INTERDISCIPLINARY NEUROSURGERY 2023. [DOI: 10.1016/j.inat.2023.101762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/28/2023] Open

Menon G, Macharla A, Srinivasan S, Santosh S, Pai A, Nair R, Hegde A. Spontaneous Intracerebral Hemorrhage in the Young: An Institutional Registry Analysis. Ann Indian Acad Neurol 2023;26:502-506. [PMID: 37970280 PMCID: PMC10645210 DOI: 10.4103/aian.aian_76_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 11/17/2023] Open

Xu EX, Lu SY, Chen B, Ma XD, Sun EY. Manifestation of the malignant progression of glioma following initial intracerebral hemorrhage: A case report. World J Clin Cases 2023;11:1576-1585. [PMID: 36926402 PMCID: PMC10011987 DOI: 10.12998/wjcc.v11.i7.1576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/03/2022] [Accepted: 02/16/2023] [Indexed: 03/02/2023] Open

Park H, Kang HS, Cho WS. Delayed Appearance of Radiologically Occult Cerebral Arteriovenous Malformation : A Case Report and Literature Review. J Korean Neurosurg Soc 2023;66:199-204. [PMID: 36071567 PMCID: PMC10009249 DOI: 10.3340/jkns.2022.0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/06/2022] [Indexed: 11/27/2022] Open

Yang Y, Huang S, Jia Y, Song G, Ye X, Lu K, Li G, Wang F, Zhu S. A 6-month prognostic nomogram incorporating hemoglobin level for intracerebral hemorrhage in younger adults. BMC Neurol 2023;23:6. [PMID: 36609246 PMCID: PMC9817395 DOI: 10.1186/s12883-022-03039-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 12/20/2022] [Indexed: 01/09/2023] Open

Abstract

OBJECTIVE

Intracerebral hemorrhage (ICH) is the second most common subtype of stroke, with high mortality and morbidity. At present, there are no effective 6-month prognostic markers, particularly for younger patients. The aim of this research was to construct a new valuable prognostic nomogram model incorporating haemoglobin levels for adult patients with ICH.

METHODS

Patients aged between 18 and 50 presenting with intracerebral haemorrhage at the Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology between January 1st 2012 and December 31st 2018 were included in this retrospective study. Independent factors of prognosis were identified by univariate and multivariate logistic regression analyses, and a new nomogram model was constructed and validated. The clinical value of the nomogram model was subsequently explored utilizing decision curve analysis and clinical impact curves.

RESULTS

In total, 565 patients were enrolled in this study, 117 (20.7%) of whom developed an unfavourable prognosis. Infratentorial lesion (adjusted odds ratio [aOR] = 3.708, 95% confidence interval [CI], 1.490-9.227; P = 0.005) was the most significant unfavourable outcome. Age ([aOR] = 1.054; 95% CI, 1.014-1.096; P = 0.008), hematoma volume (aOR = 1.014, 95% CI, 1.002-1.027; P = 0.024), haemoglobin (aOR = 0.981, 95% CI, 0.969-0.993; P = 0.002), blood glucose (aOR = 1.135, 95% CI, 1.037-1.241; P = 0.005) and NIHSS (aOR = 1.105, 95% CI, 1.069-1.141; P < 0.001) were independent risk factors. Based on these 6 factors, the nomogram can be employed to predict early functional prognosis with high accuracy (AUC 0.791). Decision curve analysis and clinical impact curves showed an increased net benefit for utilizing the nomogram.

CONCLUSION

The haemoglobin level at admission may be an easily overlooked factor in clinical work. This new nomogram model could be a promising and convenient tool to predict the early functional prognosis of adults with ICH. More prospective multicentre studies are needed to validate these findings.

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Affiliation(s)

Yuyan Yang grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1095 Jiefang Avenue, Qiaok’ou District, Wuhan, 430030 Hubei China
Shanshan Huang grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1095 Jiefang Avenue, Qiaok’ou District, Wuhan, 430030 Hubei China
Yuchao Jia grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1095 Jiefang Avenue, Qiaok’ou District, Wuhan, 430030 Hubei China
Guini Song grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1095 Jiefang Avenue, Qiaok’ou District, Wuhan, 430030 Hubei China
Xiaodong Ye grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1095 Jiefang Avenue, Qiaok’ou District, Wuhan, 430030 Hubei China
Kai Lu grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1095 Jiefang Avenue, Qiaok’ou District, Wuhan, 430030 Hubei China
Guo Li grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1095 Jiefang Avenue, Qiaok’ou District, Wuhan, 430030 Hubei China
Furong Wang grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1095 Jiefang Avenue, Qiaok’ou District, Wuhan, 430030 Hubei China
Suiqiang Zhu grid.33199.310000 0004 0368 7223Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1095 Jiefang Avenue, Qiaok’ou District, Wuhan, 430030 Hubei China

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Periole C, Blanc C, Calvière L, Fontaine L, Viguier A, Albucher JF, Chollet F, Bonneville F, Olivot JM, Raposo N. Prevalence and characterization of cerebral small vessel disease in young adults with intracerebral hemorrhage. Int J Stroke 2023;18:102-108. [PMID: 35361018 DOI: 10.1177/17474930221093526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]

Affiliation(s)

Charlotte Periole Department of Neurology, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
Clémence Blanc Department of Neurology, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
Lionel Calvière Department of Neurology, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Toulouse NeuroImaging Center, Université de Toulouse, INSERM, UPS, Toulouse, France
Louis Fontaine Department of Neurology, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
Alain Viguier Department of Neurology, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Toulouse NeuroImaging Center, Université de Toulouse, INSERM, UPS, Toulouse, France
Jean-François Albucher Department of Neurology, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Toulouse NeuroImaging Center, Université de Toulouse, INSERM, UPS, Toulouse, France
François Chollet Department of Neurology, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Toulouse NeuroImaging Center, Université de Toulouse, INSERM, UPS, Toulouse, France
Fabrice Bonneville Toulouse NeuroImaging Center, Université de Toulouse, INSERM, UPS, Toulouse, France.,Department of Neuroradiology, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
Jean-Marc Olivot Department of Neurology, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Toulouse NeuroImaging Center, Université de Toulouse, INSERM, UPS, Toulouse, France
Nicolas Raposo Department of Neurology, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.,Toulouse NeuroImaging Center, Université de Toulouse, INSERM, UPS, Toulouse, France

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Jo YJ, Kim DH, Sohn MK, Lee J, Shin YI, Oh GJ, Lee YS, Joo MC, Lee SY, Song MK, Han J, Ahn J, Chang WH, Kim YH, Kim DY. Clinical Characteristics and Risk Factors of First-Ever Stroke in Young Adults: A Multicenter, Prospective Cohort Study. J Pers Med 2022;12:jpm12091505. [PMID: 36143290 PMCID: PMC9504439 DOI: 10.3390/jpm12091505] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/12/2022] [Accepted: 09/12/2022] [Indexed: 01/10/2023] Open

Affiliation(s)

Yea Jin Jo Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
Dae Hyun Kim Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea Department of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea
Min Kyun Sohn Department of Rehabilitation Medicine, College of Medicine, Chungnam National University, Daejon 34134, Korea
Jongmin Lee Department of Rehabilitation Medicine, Konkuk University School of Medicine, Seoul 05030, Korea
Yong-Il Shin Department of Rehabilitation Medicine, Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan 46241, Korea
Gyung-Jae Oh Department of Preventive Medicine, Wonkwang University School of Medicine, Iksan 51538, Korea
Yang-Soo Lee Department of Rehabilitation Medicine, Kyungpook National University School of Medicine, Kyungpook National University Hospital, Daegu 41566, Korea
Min Cheol Joo Department of Rehabilitation Medicine, Wonkwang University School of Medicine, Iksan 51538, Korea
So Young Lee Department of Rehabilitation Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju 63243, Korea
Min-Keun Song Department of Physical and Rehabilitation Medicine, Chonnam National University Medical School, Kwangju 61186, Korea
Junhee Han Department of Statistics, Hallym University, Chunchon 24252, Korea
Jeonghoon Ahn Department of Health Convergence, Ewha Womans University, Seoul 03760, Korea
Won Hyuk Chang Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea
Yun-Hee Kim Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea Department of Health Science and Technology, Department of Medical Device Management and Research, Department of Digital Healthcare, SAIHST, Sungkyunkwan University, Seoul 03063, Korea Correspondence: (Y.-H.K.); (D.Y.K.)
Deog Young Kim Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea Department of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul 03722, Korea Correspondence: (Y.-H.K.); (D.Y.K.)

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Ojala J, Vanhanen J, Harno H, Lioumis P, Vaalto S, Kaunisto MA, Putaala J, Kangasniemi M, Kirveskari E, Mäkelä JP, Kalso E. A Randomized, Sham-Controlled Trial of Repetitive Transcranial Magnetic Stimulation Targeting M1 and S2 in Central Poststroke Pain: A Pilot Trial. Neuromodulation 2022;25:538-548. [PMID: 35670063 DOI: 10.1111/ner.13496] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 06/13/2021] [Accepted: 06/21/2021] [Indexed: 12/12/2022]

Abstract

OBJECTIVES

Central poststroke pain (CPSP), a neuropathic pain condition, is difficult to treat. Repetitive transcranial magnetic stimulation (rTMS) targeted to the primary motor cortex (M1) can alleviate the condition, but not all patients respond. We aimed to assess a promising alternative rTMS target, the secondary somatosensory cortex (S2), for CPSP treatment.

MATERIALS AND METHODS

This prospective, randomized, double-blind, sham-controlled three-arm crossover trial assessed navigated rTMS (nrTMS) targeted to M1 and S2 (10 sessions, 5050 pulses per session at 10 Hz). Participants were evaluated for pain, depression, anxiety, health-related quality of life, upper limb function, and three plasticity-related gene polymorphisms including Dopamine D2 Receptor (DRD2). We monitored pain intensity and interference before and during stimulations and at one month. A conditioned pain modulation test was performed using the cold pressor test. This assessed the efficacy of the descending inhibitory system, which may transmit TMS effects in pain control.

RESULTS

We prescreened 73 patients, screened 29, and included 21, of whom 17 completed the trial. NrTMS targeted to S2 resulted in long-term (from baseline to one-month follow-up) pain intensity reduction of ≥30% in 18% (3/17) of participants. All stimulations showed a short-term effect on pain (17-20% pain relief), with no difference between M1, S2, or sham stimulations, indicating a strong placebo effect. Only nrTMS targeted to S2 resulted in a significant long-term pain intensity reduction (15% pain relief). The cold pressor test reduced CPSP pain intensity significantly (p = 0.001), indicating functioning descending inhibitory controls. The homozygous DRD2 T/T genotype is associated with the M1 stimulation response.

CONCLUSIONS

S2 is a promising nrTMS target in the treatment of CPSP. The DRD2 T/T genotype might be a biomarker for M1 nrTMS response, but this needs confirmation from a larger study.

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Affiliation(s)

Juhani Ojala Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Jukka Vanhanen HUS Diagnostic Center, Clinical Neurophysiology, Clinical Neurosciences, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; BioMag Laboratory, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Hanna Harno Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Pantelis Lioumis BioMag Laboratory, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland
Selja Vaalto HUS Diagnostic Center, Clinical Neurophysiology, Clinical Neurosciences, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Mari A Kaunisto Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
Jukka Putaala Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Marko Kangasniemi HUS Diagnostic Center, Department of Radiology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Erika Kirveskari HUS Diagnostic Center, Clinical Neurophysiology, Clinical Neurosciences, Helsinki University Hospital and University of Helsinki, Helsinki, Finland; BioMag Laboratory, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Jyrki P Mäkelä BioMag Laboratory, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
Eija Kalso Department of Anaesthesiology, Intensive Care and Pain Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland

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Feng Y, Ji M, Ren Y, Liu Z, Xin Z, Wang L. Repeated intracerebral hemorrhage after craniotomy for a distal middle cerebral artery aneurysm: A case report. Medicine (Baltimore) 2022;101:e29223. [PMID: 35512081 PMCID: PMC9276195 DOI: 10.1097/md.0000000000029223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/15/2022] [Indexed: 01/04/2023] Open

Integrated Multiomics Analysis Identifies a Novel Biomarker Associated with Prognosis in Intracerebral Hemorrhage. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021;2021:2510847. [PMID: 36226158 PMCID: PMC8691985 DOI: 10.1155/2021/2510847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 10/29/2021] [Indexed: 11/22/2022]

Abstract

Existing treatments for intracerebral hemorrhage (ICH) are unable to satisfactorily prevent development of secondary brain injury after ICH and multiple pathological mechanisms are involved in the development of the injury. In this study, we aimed to identify novel genes and proteins and integrated their molecular alternations to reveal key network modules involved in ICH pathology. A total of 30 C57BL/6 male mice were used for this study. The collagenase model of ICH was employed, 3 days after ICH animals were tested neurological. After it, animals were euthanized and perihematomal brain tissues were collected for transcriptome and TMT labeling-based quantitative proteome analyses. Protein-protein interaction (PPI) network, Gene Set Enrichment Analysis (GSEA), and regularized Canonical Correlation Analysis (rCCA) were performed to integrated multiomics data. For validation of hub genes and proteins, qRT-PCR and Western blot were carried out. The candidate biomarkers were further measured by ELISA in the plasma of ICH patients and the controls. A total of 2218 differentially expressed genes (DEGs) and 353 differentially expressed proteins (DEPs) between the ICH model group and control group were identified. GSEA revealed that immune-related gene sets were prominently upregulated and significantly enriched in pathways of inflammasome complex, negative regulation of interleukin-12 production, and pyroptosis during the ICH process. The rCCA network presented two highly connective clusters which were involved in the sphingolipid catabolic process and inflammatory response. Among ten hub genes screened out by integrative analysis, significantly upregulated Itgb2, Serpina3n, and Ctss were validated in the ICH group by qRT-PCR and Western blot. Plasma levels of human SERPINA3 (homologue of murine Serpina3n) were elevated in ICH patients compared with the healthy controls (SERPINA3: 13.3 ng/mL vs. 11.2 ng/mL, p = 0.015). Within the ICH group, higher plasma SERPINA3 levels with a predictive threshold of 14.31 ng/mL (sensitivity = 64.3%; specificity = 80.8%; AUC = 0.742, 95% CI: 0.567-0.916) were highly associated with poor outcome (mRS scores 4-6). Taken together, the results of our study exhibited molecular changes related to ICH-induced brain injury by multidimensional analysis and effectively identified three biomarker candidates in a mouse ICH model, as well as pointed out that Serpina3n/SERPINA3 was a potential biomarker associated with poor functional outcome in ICH patients.

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Chen CY, Lin PT, Wang YH, Syu RW, Hsu SL, Chang LH, Tsai JY, Huang HC, Liu TC, Lin CJ, Tang CW, Hsu LC, Chung CP, Liu HY, Chi NF, Lee IH. Etiology and risk factors of intracranial hemorrhage and ischemic stroke in young adults. J Chin Med Assoc 2021;84:930-936. [PMID: 34380990 DOI: 10.1097/jcma.0000000000000598] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open

Abstract

BACKGROUND

Young stroke incidence has increased worldwide with lifestyle changes. Etiology and risk factors for both ischemic and hemorrhagic stroke in young Asians remain underexplored.

METHODS

We retrospectively reviewed consecutive acute stroke patients aged 16-45 years admitted to the Taipei Veterans General Hospital between 2009 and 2019 to analyze etiologic subtypes, risk factors, and serial modified Rankin Scale scores for 1 year and compare the age groups of 16-30 and 31-45 years.

RESULTS

Among 670 young Taiwanese patients (mean age at onset 37.5 ± 7.0 years; male 65.1%), there were 366 nontraumatic spontaneous hemorrhagic stroke (including 259 intracerebral hemorrhage [ICH] and 107 subarachnoid hemorrhage, SAH), 292 ischemic stroke and 12 cerebral venous thromboses. Notably, ICH was more prevalent in patients aged 16-30 than in those aged 31-45 (54.8% vs 36.8%). Specifically, structural vasculopathy (e.g., arteriovenous malformation, cavernoma) was the most common etiologic subtype in patients aged 16-30 (p < 0.001), whereas hypertensive ICH was the most common subtype in patients aged 31-45 (p < 0.001). On the other hand, the top ischemic subtype for both age groups was other determined diseases (e.g., arterial dissection, autoimmune diseases, moyamoya disease, etc.) rather than large artery atherosclerosis. Hyperlipidemia, diabetes, and cigarette smoking were more common risk factors for infarction than ICH. Familial stroke patients whose first- or second-degree relatives had a stroke by age 80 (n = 104, 15.5%) had more infarctions than those without a familial stroke history. In multivariate analyses, initial stroke severity, and infarction type were important predictors of favorable outcomes after 3 months. At the 1-year follow-up, patients with ICH and SAH had worse functional outcomes and survival rates than those with infarction.

CONCLUSION

An aggressive approach to elucidate the etiology of stroke is indicated because structural vasculopathy-induced ICH and other determined infarction are distinctively prevalent in young adults, particularly those aged 16-30.

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Affiliation(s)

Chun-Yu Chen Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC Department of Medicine, Taipei Veterans General Hospital Yuli Branch, Hualian, Taiwan, ROC
Po-Tso Lin Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
Yun-Huei Wang Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
Ruei-Wun Syu Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC Medical Department, Taipei Veterans General Hospital Hsinchu branch, Hsinchu, Taiwan, ROC
Shao-Lun Hsu Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
Li-Hsin Chang Institute of Brain Science, Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
Jui-Yao Tsai Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
Hui-Chi Huang Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
Tzu-Ching Liu Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
Chun-Jen Lin Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
Chih-Wei Tang Department of Neurology, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC
Li-Chi Hsu Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
Chih-Ping Chung Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
Hung-Yu Liu Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
Nai-Fang Chi Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
I-Hui Lee Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC Institute of Brain Science, Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC

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Malhotra K, Zompola C, Theodorou A, Katsanos AH, Shoamanesh A, Gupta H, Beshara S, Goyal N, Chang J, Tayal AH, Boviatsis E, Voumvourakis K, Cordonnier C, Werring DJ, Alexandrov AV, Tsivgoulis G. Prevalence, Characteristics, and Outcomes of Undetermined Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis. Stroke 2021;52:3602-3612. [PMID: 34344165 DOI: 10.1161/strokeaha.120.031471] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]

Abstract

BACKGROUND AND PURPOSE

There are scarce data regarding the prevalence, characteristics and outcomes of intracerebral hemorrhage (ICH) of undetermined (unknown or cryptogenic) etiology. We sought to determine the prevalence, radiological characteristics, and clinical outcomes of undetermined ICH.

METHODS

Systematic review and meta-analysis of studies involving patients with spontaneous ICH was conducted to primarily assess the prevalence and clinical-radiological characteristics of undetermined ICH. Additionally, we assessed the rates for ICH secondary to hypertensive arteriopathy and cerebral amyloid angiopathy. Subgroup analyses were performed based on the use of (1) etiology-oriented ICH classification, (2) detailed neuroimaging, and (3) Boston criteria among patients with cerebral amyloid angiopathy related ICH. We pooled the prevalence rates using random-effects models, and assessed the heterogeneity using Cochran Q and I² statistics.

RESULTS

We identified 24 studies comprising 15 828 spontaneous ICH patients (mean age, 64.8 years; men, 60.8%). The pooled prevalences of hypertensive arteriopathy ICH, undetermined ICH, and cerebral amyloid angiopathy ICH were 50% (95% CI, 43%-58%), 18% (95% CI, 13%-23%), and 12% (95% CI, 7%-17% [P<0.001 between subgroups]). The volume of ICH was the largest in cerebral amyloid angiopathy ICH (24.7 [95% CI, 19.7-29.8] mL), followed by hypertensive arteriopathy ICH (16.2 [95% CI, 10.9-21.5] mL) and undetermined ICH (15.4 [95% CI, 6.2-24.5] mL). Among patients with undetermined ICH, the rates of short-term mortality (within 3 months) and concomitant intraventricular hemorrhage were 33% (95% CI, 25%-42%) and 38% (95% CI, 28%-48%), respectively. Subgroup analysis demonstrated a higher rate of undetermined ICH among studies that did not use an etiology-oriented classification (22% [95% CI, 15%-29%]). No difference was observed between studies based on the completion of detailed neuroimaging to assess the rates of undetermined ICH (P=0.62).

CONCLUSIONS

The etiology of spontaneous ICH remains unknown or cryptogenic among 1 in 7 patients in studies using etiology-oriented classification and among 1 in 4 patients in studies that avoid using etiology-oriented classification. The short-term mortality in undetermined ICH is high despite the relatively small ICH volume.

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Affiliation(s)

Konark Malhotra Department of Neurology, Allegheny Health Network, Pittsburgh, PA (K.M., A.H.T.)
Christina Zompola Second Department of Neurology, National and Kapodistrian University of Athens, "Attikon" University Hospital, Greece. (C.Z., A.T., A.H.K., K.V., G.T.)
Aikaterini Theodorou Second Department of Neurology, National and Kapodistrian University of Athens, "Attikon" University Hospital, Greece. (C.Z., A.T., A.H.K., K.V., G.T.)
Aristeidis H Katsanos Department of Neurology, Allegheny Health Network, Pittsburgh, PA (K.M., A.H.T.).,Second Department of Neurology, National and Kapodistrian University of Athens, "Attikon" University Hospital, Greece. (C.Z., A.T., A.H.K., K.V., G.T.).,Department of Neurology, McMaster University/Population Health Research Institute, Hamilton, Canada (A.H.K., A.S., H.G.)
Ashkan Shoamanesh Department of Neurology, McMaster University/Population Health Research Institute, Hamilton, Canada (A.H.K., A.S., H.G.)
Himanshu Gupta Department of Neurology, McMaster University/Population Health Research Institute, Hamilton, Canada (A.H.K., A.S., H.G.)
Simon Beshara Department of Neurology, Queen's University, Kingston, Ontario (S.B., A.V.A., G.T.)
Nitin Goyal Department of Neurology, University of Tennessee Health Science Center, Memphis, TN (N.G.)
Jason Chang Department of Neurology, MedStar Washington Hospital Center, Washington, DC (J.C.)
Ashis H Tayal
Efstathios Boviatsis Department of Neurosurgery, National and Kapodistrian University of Athens, "Attikon" University Hospital, Greece. (E.B.)
Konstantinos Voumvourakis Second Department of Neurology, National and Kapodistrian University of Athens, "Attikon" University Hospital, Greece. (C.Z., A.T., A.H.K., K.V., G.T.)
Charlotte Cordonnier Department of Neurology, Université Lille, Inserm, CHU Lille, U1172, LilNCog, Lille Neuroscience and Cognition, France (C.C.)
David J Werring Stroke Research Centre, UCL Queen Square Institute of Neurology, London, United Kingdom (D.J.W.)
Andrei V Alexandrov Department of Neurology, Queen's University, Kingston, Ontario (S.B., A.V.A., G.T.)
Georgios Tsivgoulis Second Department of Neurology, National and Kapodistrian University of Athens, "Attikon" University Hospital, Greece. (C.Z., A.T., A.H.K., K.V., G.T.).,Department of Neurology, Queen's University, Kingston, Ontario (S.B., A.V.A., G.T.)

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Cho S, Rehni AK, Dave KR. Tobacco Use: A Major Risk Factor of Intracerebral Hemorrhage. J Stroke 2021;23:37-50. [PMID: 33600701 PMCID: PMC7900392 DOI: 10.5853/jos.2020.04770] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/20/2021] [Indexed: 12/23/2022] Open

Ischemia-modified albumin and fibulin-5 as diagnostic and prognostic markers for acute cerebrovascular disease. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2021. [DOI: 10.1186/s41983-020-00264-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open

Acupuncture Ameliorates Neuronal Cell Death, Inflammation, and Ferroptosis and Downregulated miR-23a-3p After Intracerebral Hemorrhage in Rats. J Mol Neurosci 2021;71:1863-1875. [PMID: 33403590 DOI: 10.1007/s12031-020-01770-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/02/2020] [Indexed: 12/15/2022]

Abstract

Baihui-penetrating-Qubin acupuncture is frequently used to treat intracerebral hemorrhage (ICH) in China. Acupuncture affects multiple microRNAs in diseases. MicroRNA-23a-3p (miR-23a-3p) has been demonstrated to be up-regulated in ICH patients. Herein, the effect of Baihui-penetrating-Qubin acupuncture on miR-23a-3p expression after ICH and the role of miR-23a-3p in ICH were discussed. A rat model of ICH was induced by infusing autologous blood into caudate nucleus. Acupuncture was performed after ICH once a day for 30 min. After 3 consecutive days of acupuncture, the neurobehavioral function, brain edema, neuronal cell death, inflammation, ferroptosis, nuclear factor E2-like 2 (NFE2L2) signaling and miR-23a-3p levels in brain tissues were analyzed. Additionally, antagomiR-23a-3p was injected into rats 3 days prior to ICH modeling to analyze the function of miR-23a-3p in neuronal cell death, inflammation, ferroptosis, and NFE2L2 signaling. Acupuncture relieved the ICH-induced neurological function deficits, increases in brain water content and Fluoro-Jade B (FJB)-positive cells and release of proinflammatory cytokines. Acupuncture also alleviated ferroptosis and decreased miR-23a-3p expression, as evidenced by the increased NFE2L2 nuclear translocation and expressions of heme oxygenase-1 and glutathione peroxidase 4 and the decreased iron and malondialdehyde contents and reactive oxygen species accumulation. Additionally, antagomiR-23a-3p inhibited the ICH-induced increases in FJB-positive cells, release of proinflammatory cytokines, ferroptosis, and promoted NFE2L2 activation. Notably, the binding site of miR-23a-3p existed in NFE2L2. Taken together, acupuncture may alleviate the neuronal cell death, inflammation, and ferroptosis after ICH by down-regulating miR-23a-3p. This study provides a potential mechanism underlying the Baihui-penetrating-Qubin acupuncture improving the early injury after ICH.

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Elmegiri M, Koivunen RJ, Tatlisumak T, Putaala J, Martola J. MRI Characterization of Non-traumatic Intracerebral Hemorrhage in Young Adults. Front Neurol 2020;11:558680. [PMID: 33192991 PMCID: PMC7658320 DOI: 10.3389/fneur.2020.558680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 09/16/2020] [Indexed: 11/18/2022] Open

Abstract

Background and Purpose: Non-traumatic intracerebral hemorrhage (ICH) in younger population is a relatively rare event but is associated with considerable mortality and poor functional outcome. Imaging plays a crucial role in determining the underlying cause and guide treatment of ICH. In up to 41% of patients in prior studies, the underlying cause remained elusive. However, the usage of MRI as part of diagnostic work-up was scanty. We aimed to analyze MRI findings of ICH in younger patients and assess specificity and sensitivity of MRI in detecting structural or local underlying causes of ICH.

Methods: We included patients aged 15–49 years with first-ever ICH identified from a prospective hospital discharge registry, 2000–2010. All study patients underwent MRI within 3 months of ICH. Imaging data was analyzed by a senior neuroradiologist blinded to final clinical diagnosis. We calculated the diagnostic accuracy of MRI in detecting structural/local underlying causes.

Results: Of our 116 patients (median age, 39; 67% males), structural/local causes were the leading causes of ICH (50.0%), and of these, bleeding cavernomas (23.3%) were the most frequent followed by arteriovenous malformations (12.9%), cerebral venous thrombosis (CVT) (7.8%), brain tumors (5.2%), and moyamoya disease (0.9%). Lobar location of ICH was more prevalent in younger patients. MRI was highly sensitive (90.0%; 95% confidence interval, 79.5–96.2%) for detection of structural/local causes compared with angiographic imaging (55.6%; 95% CI, 40.0–70.4%), while MRI was less specific (87.3%; 95% CI, 75.5–94.7%) for structural/local causes, compared with angiographic imaging (97.4%; 95% CI, 86.5–99.9%).

Conclusion: MRI was highly sensitive for the detection of structural and local causes underlying ICH in young adults. Thus, MRI should be considered in the diagnostic work-up of all young ICH patients to enable targeted secondary prevention.

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Enriquez CAG, Omar AT, Medrano JMM, Diestro JDB, Ochoco GETD, Spears J, Khu KJO, Pineda-Franks MC. Non-Traumatic Intracerebral Hematoma in the Young: Findings from a Tertiary Hospital in the Philippines. J Stroke Cerebrovasc Dis 2020;29:105242. [PMID: 33066927 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/01/2020] [Accepted: 08/06/2020] [Indexed: 11/30/2022] Open

Kim BD, Kurian C, Stein LK, Tuhrim S, Dhamoon MS. Index Admission Characteristics and All-Cause Readmissions Analysis in Younger and Older Adults with Intracerebral Hemorrhage. Cerebrovasc Dis 2020;49:375-381. [PMID: 32829328 DOI: 10.1159/000509839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 06/29/2020] [Indexed: 11/19/2022] Open

Abstract

INTRODUCTION

Intracerebral hemorrhage (ICH) comprises 15-20% of all strokes with debilitating consequences. Data regarding characteristics and outcomes of primary ICH in the young are lacking, given its rarity, making comparisons between younger and older cohorts difficult to perform. Nationally representative administrative databases enable analysis of such rare events.

OBJECTIVE

To determine the baseline characteristics, all-cause readmission rates, and reasons for primary ICH in younger and older adults using a nationally representative database.

METHODS

A retrospective cohort analysis was performed using the Nationwide Readmissions Database 2013. Validated ICD-9-CM codes identified index ICH admissions, comorbidities, demographics, behavioral risk factors, procedures, and Elixhauser and Charlson Comorbidity indices. We compared "younger" (age ≤ 45 years) and "older" (age > 45) index ICH admissions by weighted 30-day all-cause readmission rates, primary diagnosis code for 30-day readmissions, most common comorbidities during the index hospitalization, and Kaplan-Meier cumulative risk of readmission up to 1 year.

RESULTS

Older admissions had higher comorbidity scores and mortality, but both groups had similar total comorbidities. Younger admissions exhibited longer length of stay with more procedures performed. Vascular anomalies (aneurysm 7.2 vs. 4.6% and arteriovenous malformation 5.9 vs. 0.8%) and behavioral risk factors (smoking 26.5 vs. 23.0%, alcohol abuse 6.7 vs. 4.6%, and substance use 13.5 vs. 2.9%) were more prevalent in younger admissions, while older patients had more cardiovascular comorbidities. All-cause 30-day readmission rates (13.1 vs. 13.0%) and 1-year cumulative risk of readmission (log-rank p value 0.7209) were similar. Readmissions in the younger cohort were primarily for neurological conditions, and those in the older cohort were for systemic conditions.

CONCLUSIONS

Adults <45 years with ICH had similar total comorbidities as older adults but more procedures, longer hospital stay, and more behavioral risk factors. Readmission rates were similar though reasons differed; younger patients were more for neurological reasons than for other systemic causes.

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Mello TG, Rosado-de-Castro PH, Campos RMP, Vasques JF, Rangel-Junior WS, Mattos RSDARD, Puig-Pijuan T, Foerster BU, Gutfilen B, Souza SAL, Boltze J, Paiva FF, Mendez-Otero R, Pimentel-Coelho PM. Intravenous Human Umbilical Cord-Derived Mesenchymal Stromal Cell Administration in Models of Moderate and Severe Intracerebral Hemorrhage. Stem Cells Dev 2020;29:586-598. [PMID: 32160799 DOI: 10.1089/scd.2019.0176] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open

Affiliation(s)

Tanira Giara Mello Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Instituto de Engenharia Nuclear, Comissão Nacional de Energia Nuclear, Rio de Janeiro, Brazil.,Instituto Nacional de Ciência e Tecnologia em Medicina Regenerativa, Rio de Janeiro, Brazil
Paulo Henrique Rosado-de-Castro Instituto Nacional de Ciência e Tecnologia em Medicina Regenerativa, Rio de Janeiro, Brazil.,Departamento de Radiologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Instituto de Ciências Biomédicas, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Raquel Maria Pereira Campos Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Juliana Ferreira Vasques Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Instituto Nacional de Ciência e Tecnologia em Medicina Regenerativa, Rio de Janeiro, Brazil
William Simões Rangel-Junior Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Raphael Santos de Almeida Rezende de Mattos Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Teresa Puig-Pijuan Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Instituto Nacional de Ciência e Tecnologia em Medicina Regenerativa, Rio de Janeiro, Brazil
Bernd Uwe Foerster Instituto de Física de São Carlos, Universidade de São Paulo, São Carlos, Brazil
Bianca Gutfilen Departamento de Radiologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Sergio Augusto Lopes Souza Departamento de Radiologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
Johannes Boltze School of Life Sciences, University of Warwick, Coventry, United Kingdom
Fernando Fernandes Paiva Instituto de Física de São Carlos, Universidade de São Paulo, São Carlos, Brazil
Rosalia Mendez-Otero Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Instituto Nacional de Ciência e Tecnologia em Medicina Regenerativa, Rio de Janeiro, Brazil
Pedro Moreno Pimentel-Coelho Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.,Instituto Nacional de Ciência e Tecnologia em Medicina Regenerativa, Rio de Janeiro, Brazil

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Hypertension is a Leading Cause of Nontraumatic Intracerebral Hemorrhage in Young Adults. J Stroke Cerebrovasc Dis 2020;29:104719. [PMID: 32122779 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104719] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/30/2020] [Accepted: 02/02/2020] [Indexed: 12/27/2022] Open

Abstract

OBJECTIVE

To evaluate the etiology and discharge outcome of nontraumatic intracerebral hemorrhage (ICH) in young adults admitted to a comprehensive stroke center.

METHODS

A retrospective chart review was performed on patients with a discharge diagnosis of nontraumatic ICH admitted from 7/1/2011 to 6/30/2016. Data was collected on demographics, clinical history, ICH score, hemorrhage location, do-not-resuscitate (DNR) orders, likely etiology, and discharge disposition. Categorical data was reported as percentage. Chi-squared test was performed to evaluate association of location of ICH, etiology of ICH, and ICH score with the discharge outcome.

RESULTS

Sixty-three patients met the study criteria, with mean age 35.4 ± 6.4 years including 26 (41%) women and 40 (64%) whites. Headache (65%) and change in mental status (48%) were the most common presenting symptoms. Hemorrhage was most commonly seen in the deep structures in 29 (46%) patients followed by lobar ICH in 14 (22%) patients. The most common etiology of ICH was hypertension in 23 (37%) patients, followed by vascular abnormalities in 18 (29%) patients. Forty-two (67%) had good outcome defined as discharge to home (n = 25) or acute inpatient rehabilitation (n = 17). Twenty-one (33%) patients had bad outcome with discharge to skilled nursing facility (n = 6), hospice (n = 1) or died in the hospital (n = 14). Hospital DNR orders were noted in 11 (18%) patients. Higher ICH score (P < .0001) and use of DNR orders (P < .0001) were associated with bad outcome. All 11 patients with DNR orders died in the hospital. Location or etiology of hemorrhage were not associated with discharge outcome.

CONCLUSIONS

Hypertension, a modifiable risk factor, is a major cause of nontraumatic ICH in young adults. Aggressive management of hypertension is essential to halt the recent increased trends of ICH due to hypertension. Early DNR orders may need to be cautiously used in the hospital.

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Bernardo F, Rebordão L, Machado S, Salgado V, Pinto AN. In-Hospital and Long-Term Prognosis after Spontaneous Intracerebral Hemorrhage among Young Adults Aged 18-65 Years. J Stroke Cerebrovasc Dis 2019;28:104350. [PMID: 31492627 DOI: 10.1016/j.jstrokecerebrovasdis.2019.104350] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/21/2019] [Accepted: 08/11/2019] [Indexed: 11/26/2022] Open

Ironside N, Chen CJ, Pucci J, Connolly ES. Effect of Cigarette Smoking on Functional Outcomes in Patients with Spontaneous Intracerebral Hemorrhage. J Stroke Cerebrovasc Dis 2019;28:2496-2505. [PMID: 31279697 DOI: 10.1016/j.jstrokecerebrovasdis.2019.06.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/25/2019] [Accepted: 06/08/2019] [Indexed: 01/09/2023] Open

Abstract

BACKGROUND

Nicotine may have neuroprotective effects on the injured brain through modulation of the cholinergic anti-inflammatory pathway.

AIMS

This study aimed to evaluate the relationship between cigarette smoking and outcomes in patients with spontaneous intracerebral hemorrhage (ICH).

METHODS

This was a retrospective review of consecutive ICH patients enrolled in the ICH Outcomes Project from 2009 to 2017. Patients with age ≥18 years and baseline modified Rankin Scale (mRS) score 0-2 were included. Smoking patterns were categorized as recent smoker (≤30 days prior to ICH) and not recent smoker (>30 days prior to ICH). Not recent smokers were further categorized into former smokers and nonsmokers. The primary outcome was good outcome (90-day mRS ≤ 2). Secondary outcomes were excellent outcome (90-day mRS 0-1), 90-day Barthel Index, and in-hospital and 90-day mortality.

RESULTS

The study cohort comprised 545 patients, including 60 recent smokers and 485 not recent smokers. Recent smokers had higher rates of good (35% versus 23%; odds ratio [OR] = 1.787, P = .047) and excellent (25% versus 13%; OR = 2.220, P = .015) outcomes compared to not recent smokers. These differences were not significant after baseline adjustments. Recent smokers had higher rates of good (36% versus 24%; OR = 1.732, P = .063) and excellent (25% versus 13%; OR = 2.203, P = .018) outcomes compared to nonsmokers. These differences were not significant after baseline adjustments. A 90-day Barthel Index, in-hospital, and 90-day mortality were comparable between recent and not recent smokers, recent and nonsmokers, and former and nonsmokers.

CONCLUSIONS

Despite potential neuroprotective effects of nicotine found in cigarettes, these may be outweighed by the detrimental effects of cigarette smoking on health outcomes.

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Is nontraumatic intracerebral hemorrhage different between young and elderly patients? Neurosurg Rev 2019;43:781-791. [PMID: 31161443 DOI: 10.1007/s10143-019-01120-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/29/2019] [Accepted: 05/21/2019] [Indexed: 01/05/2023]

Abstract

Only a few studies have reported nontraumatic intracerebral hemorrhage in young patients notwithstanding its fatal and devastating characteristics. This study investigated the clinical characteristics and outcome of nontraumatic intracerebral hemorrhage in young patients in comparison to those of the elderly. A retrospective review of consecutive patients admitted at the department of neurosurgery of two tertiary care medical centers presenting with first-ever nontraumatic intracerebral hemorrhage was performed. We identified and compared the demographics, etiologies, risk factors, and laboratory, radiological, and clinical findings between elderly and young patients. Additionally, logistic regression analyses of independent prognostic factors associated with 1-month mortality and favorable functional outcome were performed. Altogether, 247 patients including 69 young patients and 178 elderly patients were enrolled. On multivariate analysis, young patients exhibited significantly more often an infratentorial hematoma location, excessive alcohol consumption, and high body mass index (BMI), but less frequent systemic hypertension. There was no statistical difference between the two groups in 1-month mortality (17.46% and 18.01% for young and elderly patients, respectively), but the favorable functional outcome based on modified Rankin scale score of 0 or 1 was significantly different between the two groups (favorable outcome in 51.79% and 29.93% of patients, respectively). Predictors of 1-month mortality was the presence of herniation in the young group, and lower Glasgow Coma Scale score, renal or heart disease, and leukocytosis (WBC > 10,000) in the elderly group. Lower National Institutes Health Stroke Scale score was associated with favorable functional outcome in both groups. Nontraumatic intracerebral hemorrhage in younger patients appears to be associated with excessive alcohol consumption and high BMI. Younger patients had similar short-term mortality but more favorable functional outcome than the elderly.

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Ventricular Assist Device Patients Have Different Clinical Outcomes and Altered Patterns of Bleeding with Intracranial Hemorrhage. ASAIO J 2019;64:e55-e60. [PMID: 29432298 DOI: 10.1097/mat.0000000000000744] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open

Hessington A, Tsitsopoulos PP, Fahlström A, Marklund N. Favorable clinical outcome following surgical evacuation of deep-seated and lobar supratentorial intracerebral hemorrhage: a retrospective single-center analysis of 123 cases. Acta Neurochir (Wien) 2018;160:1737-1747. [PMID: 30051159 PMCID: PMC6105225 DOI: 10.1007/s00701-018-3622-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 07/17/2018] [Indexed: 12/04/2022]

Abstract

Background

In spontaneous supratentorial intracerebral hemorrhage (ICH), the role of surgical treatment remains controversial, particularly in deep-seated ICHs. We hypothesized that early mortality and long-term functional outcome differ between patients with surgically treated lobar and deep-seated ICH.

Method

Patients who underwent craniotomy for ICH evacuation from 2009 to 2015 were retrospectively evaluated and categorized into two subgroups: lobar and deep-seated ICH. The modified Rankin Scale (mRS) was used to evaluate long-term functional outcome.

Result

Of the 123 patients operated for ICH, 49.6% (n = 61) had lobar and 50.4% (n = 62) deep-seated ICH. At long-term follow-up (mean 4.2 years), 25 patients (20.3%) were dead, while 51.0% of survivors had a favorable outcome (mRS score ≤ 3). Overall mortality was 13.0% at 30 days and 17.9% at 6 months post-ictus, not influenced by ICH location. Mortality was higher in patients ≥ 65 years old (p = 0.020). The deep-seated group had higher incidence and extent of intraventricular extension, younger age (52.6 ± 9.0 years vs. 58.5 ± 9.8 years; p < 0.05), more frequently pupillary abnormalities, and longer neurocritical care stay (p < 0.05). The proportion of patients with good outcome was 48.0% in deep-seated vs. 54.1% in lobar ICH (p = 0.552). In lobar ICH, independent predictors of long-term outcome were age, hemorrhage volume, preoperative level of consciousness, and pupillary reaction. In deep-seated ICHs, only high age correlated significantly with poor outcome.

Conclusions

At long-term follow-up, most ICH survivors had a favorable clinical outcome. Neither mortality nor long-term functional outcome differed between patients operated for lobar or deep-seated ICH. A combination of surgery and neurocritical care can result in favorable clinical outcome, regardless of ICH location.

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Zhou HX, Hao N, Xu XL. Related Factors of Early Mortality in Young Adults with Cerebral Hemorrhage. Open Med (Wars) 2018;13:214-220. [PMID: 29915811 PMCID: PMC6004518 DOI: 10.1515/med-2018-0033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 03/14/2018] [Indexed: 01/08/2023] Open

Mustanoja S, Putaala J, Koivunen R, Surakka I, Tatlisumak T. Blood pressure levels in the acute phase after intracerebral hemorrhage are associated with mortality in young adults. Eur J Neurol 2018;25:1034-1040. [DOI: 10.1111/ene.13662] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 02/28/2018] [Indexed: 01/18/2023]

Tatlisumak T, Cucchiara B, Kuroda S, Kasner SE, Putaala J. Nontraumatic intracerebral haemorrhage in young adults. Nat Rev Neurol 2018. [PMID: 29521335 DOI: 10.1038/nrneurol.2018.17] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]

Charidimou A, Morotti A, Valenti R, Giese AK, Boulouis G, Pasi M, Roongpiboonsopit D, Lauer A, Xiong L, Van Harten TW, Karadeli H, Fotiadis P, Jessel MJ, Viswanathan A. Journal Club: Time trends in incidence, case fatality, and mortality of intracerebral hemorrhage. Neurology 2018;86:e206-9. [PMID: 27185900 DOI: 10.1212/wnl.0000000000002678] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open

Affiliation(s)

Andreas Charidimou From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA.
Andrea Morotti From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA
Raffaella Valenti From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA
Anne-Katrin Giese From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA
Gregoire Boulouis From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA
Marco Pasi From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA
Duangnapa Roongpiboonsopit From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA
Arne Lauer From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA
Li Xiong From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA
Thijs Wijnzen Van Harten From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA
Hasan Karadeli From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA
Panagiotis Fotiadis From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA
Michael James Jessel From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA
Anand Viswanathan From the Hemorrhagic Stroke Research Program, Department of Neurology, Massachusetts General Hospital Stroke Research Center, Harvard Medical School, Boston, MA

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Stack CA, Cole JW. A Diagnostic Approach to Stroke in Young Adults. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2017;19:84. [PMID: 28948451 DOI: 10.1007/s11936-017-0587-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]

Abstract

OPINION STATEMENT

Optimal diagnosis and management of stroke in young adults benefit from a multidisciplinary team, including a vascular neurology specialist. In addition to the "standard" vascular risk factors including smoking, hypertension, diabetes, and hyperlipidemia, one needs to consider alternative etiologies including substance abuse, carotid/vertebral artery dissections, and rare genetic conditions among others. Once a young patient is determined to have had a stroke, the next question a clinician should ask is why did this patient have a stroke? A "heart to head" diagnostic approach is recommended. A thorough history is performed, including a detailed family history with specific annotations on each family member. A thorough physical examination is necessary including a careful evaluation of the patient's general appearance, noting any joint laxity, and/or abnormalities of the skin, eyes, and heart. Findings across multiple organ systems in the patient and/or their family may indicate a genetic etiology. After an initial head CT rules out hemorrhagic stroke, additional testing should include a brain MRI, neck and cerebral vascular imaging (e.g., CTA for head and neck), transthoracic echocardiogram with a bubble study, telemetry monitoring, basic risk factor blood work (e.g., lipid panel, hemoglobin A1c, TSH, ESR, CRP, RPR, HIV, and toxicology screen), and, when appropriate, sickle screen and pregnancy test. There should be a low threshold to obtain blood cultures or a lumbar puncture. The acute treatment of ischemic stroke in young adult patients does not differ from treatment of older adults, using intravenous alteplase within 4.5 h, assuming no contraindications. In suspected proximal large artery occlusive disease, interventional clot extraction procedures should be employed in patients deemed eligible. Long-term secondary prevention strategies aimed to reduce recurrent stroke risk by targeting and modifying vascular risk factors should be instituted. The mainstay of preventative therapy is aspirin for most etiologies; however, for atrial fibrillation, anticoagulation is recommended. Statin therapy is another pharmacologic intervention recommended in most stroke patients. Other measures employed are blood pressure reduction, smoking cessation, optimal glucose control in diabetic patients, the initiation of a healthy diet and regular exercise, and lastly, substance abuse counseling in appropriate patients.

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Ågesen FN, Risgaard B, Zachariasardóttir S, Jabbari R, Lynge TH, Ingemann-Hansen O, Ottesen GL, Thomsen JL, Haunsø S, Krieger DW, Winkel BG, Tfelt-Hansen J. Sudden unexpected death caused by stroke: A nationwide study among children and young adults in Denmark. Int J Stroke 2017;13:285-291. [DOI: 10.1177/1747493017724625] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]

Huang YH, Liao CC, Yang KY. Demographics and Short-Term Outcomes of Spontaneous Subarachnoid Hemorrhage in Young Adults. World Neurosurg 2017;102:414-419. [DOI: 10.1016/j.wneu.2017.03.069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 03/15/2017] [Accepted: 03/16/2017] [Indexed: 10/19/2022]

Li GC, Zhang L, Yu M, Jia H, Tian T, Wang J, Wang F, Zhou L. Identification of novel biomarker and therapeutic target candidates for acute intracerebral hemorrhage by quantitative plasma proteomics. Clin Proteomics 2017;14:14. [PMID: 28450824 PMCID: PMC5406897 DOI: 10.1186/s12014-017-9149-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 04/14/2017] [Indexed: 12/19/2022] Open

Abstract

Background

The systematic mechanisms of acute intracerebral hemorrhage are still unknown and unverified, although many recent researches have indicated the secondary insults. This study was aimed to disclose the pathological mechanism and identify novel biomarker and therapeutic target candidates by plasma proteome.

Methods

Patients with AICH (n = 8) who demographically matched healthy controls (n = 4) were prospectively enrolled, and their plasma samples were obtained. The TMT-LC–MS/MS-based proteomics approach was used to quantify the differential proteome across plasma samples, and the results were analyzed by Ingenuity Pathway Analysis to explore canonical pathways and the relationship involved in the uploaded data.

Results

Compared with healthy controls, there were 31 differentially expressed proteins in the ICH group (P < 0.05), of which 21 proteins increased while 10 proteins decreased in abundance. These proteins are involved in 21 canonical pathways. One network with high confidence level was selected by the function network analysis, in which 23 proteins, P38MAPK and NFκB signaling pathways participated. Upstream regulator analysis found two regulators, IL6 and TNF, with an activation z-score. Seven biomarker candidates: APCS, FGB, LBP, MGMT, IGFBP2, LYZ, and APOA4 were found. Six candidate proteins were selected to assess the validity of the results by subsequent Western blotting analysis.

Conclusion

Our analysis provided several intriguing pathways involved in ICH, like LXR/RXR activation, acute phase response signaling, and production of NO and ROS in macrophages pathways. The three upstream regulators: IL-6, TNF, LPS, and seven biomarker candidates: APCS, APOA4, FGB, IGFBP2, LBP, LYZ, and MGMT were uncovered. LPS, APOA4, IGFBP2, LBP, LYZ, and MGMT are novel potential biomarkers in ICH development. The identified proteins and pathways provide new perspectives to the potential pathological mechanism and therapeutic targets underlying ICH.

Electronic supplementary material

The online version of this article (doi:10.1186/s12014-017-9149-x) contains supplementary material, which is available to authorized users.

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Joseph DM, O'Neill AH, Chandra RV, Lai LT. Glioblastoma presenting as spontaneous intracranial haemorrhage: Case report and review of the literature. J Clin Neurosci 2017;40:1-5. [PMID: 28215428 DOI: 10.1016/j.jocn.2016.12.046] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2016] [Revised: 12/05/2016] [Accepted: 12/27/2016] [Indexed: 11/19/2022]

Prognostic Significance of Intraventricular Hemorrhage in Vascular Structural Abnormality-Related Intracerebral Hemorrhage. J Stroke Cerebrovasc Dis 2017;26:636-643. [PMID: 28041901 DOI: 10.1016/j.jstrokecerebrovasdis.2016.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 10/18/2016] [Accepted: 11/13/2016] [Indexed: 02/05/2023] Open

Schapira AHV. Advances in neurological research and practice. Eur J Neurol 2016;23:1685-1693. [PMID: 27882727 DOI: 10.1111/ene.13214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]

Hu L, Dong MX, Zhao H, Xu GH, Qin XY. Fibulin-5: a novel biomarker for evaluating severity and predicting prognosis in patients with acute intracerebral haemorrhage. Eur J Neurol 2016;23:1195-201. [PMID: 27106135 DOI: 10.1111/ene.13013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 03/01/2016] [Indexed: 12/20/2022]

Zhang W, Zhao R, Li X, Cui X, Zhao Z, Mao Y, Wu F, Tang Q. Effect of Yi-nao-jie-yu decoction on γ-aminobutyric acid type A receptor in the hippocampus and serum inflammatory factors in a rat model of poststroke anxiety. Neuropsychiatr Dis Treat 2016;12:2827-2837. [PMID: 27843317 PMCID: PMC5098770 DOI: 10.2147/ndt.s115116] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open

Abstract

BACKGROUND

The Yi-nao-jie-yu decoction (YNJYD) is a herbal preparation widely used in the clinics of traditional Chinese medicine and has been recently used as an important new therapeutic agent in poststroke anxiety (PSA). The neuroendocrine-immune system plays an important role in PSA mechanisms, although the modulating effects of YNJYD remain unknown. This study investigated the potential effects of YNJYD on the neuroendocrine-immune system in a rat model of PSA.

MATERIALS AND METHODS

The PSA model was induced by injecting collagenase (type VII) into the right globus pallidus, accompanied by empty water bottle stimulation for 2 weeks. The sham group and the PSA model group were gavaged with saline, while the treatment groups received buspirone (BuSpar) or YNJYD. Behavior was evaluated with the open field test and elevated plus maze once a week. Pathological changes were observed by hematoxylin and eosin staining. Serum levels of tumor necrosis factor, interleukin (IL)-6, adrenocorticotropic hormone, thyroid stimulating hormone, free triiodothyronine, free thyroxine, IL-1α, and cortisol were detected by radioimmunoassay. Expression of the γ-aminobutyric acid type A receptor (GABA_AR) α₂ subunit was examined by Western blot and real-time polymerase chain reaction.

RESULTS

YNJYD-treated rats exhibited significantly better recovery than BuSpar-treated rats at 21 days and 28 days in the open field test and elevated plus maze. Hematoxylin and eosin staining revealed neural repair in the hippocampus in the treatment groups. Serum levels of IL-1α in the YNJYD group were significantly less than those in the model group and the BuSpar group. GABA_AR protein and mRNA expressions were higher in the PSA model group than in the sham group, and YNJYD reversed these effects.

CONCLUSION

YNJYD alleviated the symptoms of PSA mainly by decreasing IL-1α levels and downregulating GABA_AR expression in the hippocampus to maintain a neuroendocrine-mmune system balance.

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Huang Y, Chen J, Zhong S, Yuan J. Role of APACHE II scoring system in the prediction of severity and outcome of acute intracerebral hemorrhage. Int J Neurosci 2015;126:1020-4. [PMID: 26393395 DOI: 10.3109/00207454.2015.1099099] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]

Koivunen RJ, Harno H, Tatlisumak T, Putaala J. Depression, anxiety, and cognitive functioning after intracerebral hemorrhage. Acta Neurol Scand 2015;132:179-84. [PMID: 25639837 DOI: 10.1111/ane.12367] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2014] [Indexed: 12/15/2022]