The avoidance of SBP <120 mm Hg in individuals with acute ICH may help prevent cerebral ischemia and neurologic deterioration.
Models using 4 or 5 predictors have acceptable to good discrimination for determining additional intracerebral hemorrhage growth in patients with acute intracerebral hemorrhage.
Increased Systolic Blood Pressure Variability Linked to Worse Neurologic Outcomes in Intracerebral HemorrhageSeptember 13, 2018
The primary outcome was an unfavorable neurologic outcome, which was defined as a modified Rankin Scale score of 3 to 6 at 3 months following randomization.
Investigators identify clinical and neuroimaging markers associated with the presence of cortical superficial siderosis and the risk for recurrent ICH.
An inverse relationship was discovered between rising cholesterol levels and decreased risk for intracerebral hemorrhage in new statin users.
Patients with intracerebral hemorrhage who were admitted to acute stroke units were randomly assigned to either 1 gram intravenous tranexamic acid followed by an 8-hour infusion of 1 gram tranexamic acid or matched placebo.
While developing the hematoma expansion prediction score, associations between hematoma expansion and blend sign, any intrahematoma hypodensity, and time from onset to noncontrast computed tomography <2.5 hours were found.
Investigators performed a pre-planned secondary analysis of the open-label, randomized Antihypertensive Treatment of Acute Cerebral Hemorrhage 2 study, specifically on the magnetic resonance images obtained during the intensive blood pressure lowering portion of the trial.
The investigators of this study did not compare pre- or post-hemorrhage data, precluding their ability to determine the applicability of the findings for improving clinical practice.
Investigators conducted a meta-analysis of trials that reported functional outcomes and mortality rates among patients with intracerebral hemorrhage following intensive blood pressure lowering.
Further research may be necessary to better understand the pathophysiologic mechanisms involved in perihemorrhagic edema evolution and ICH.
For patients with CKD and atrial fibrillation, anticoagulants are linked with an increased risk of ischemic stroke.
Outcomes in intracerebral hemorrhage are less severe in patients with prior NOAC use.
Results from a secondary analysis of the ENCHANTED trial add to a pile of weak data that likely will not affect clinical practice.
Surprisingly, no evidence was found to suggest that patients with these markers benefit from intensive blood pressure reduction.
Intensive antiplatelet therapy appears to reduce risk of recurrence immediately after stroke, but may pose risks further out.
Resumption of oral anticoagulants after intracerebral hemorrhage was found to improve outcomes at 1 year.
The investigators reported no difference in 3-month mortality rates across all 5 studies included in the meta-analysis.
Restarting anticoagulation after both nonlobar and lobar ICH was associated with decreased mortality.
As more patients survive ICH, emphasis is slowly shifting from survival to improving ICH-related morbidity and optimization of functional recovery.
Optimal antiplatelet treatment has yet to be determined for stroke survivors with prior intracerebral hemorrhage.
Among ICH survivors, 63% developed both depression and dementia during a 5-year follow-up study.
Recent research found benefits in outcome outweighed any increase in hemorrhagic complications in patients with large infarcts.
Notably, the location of ICH influenced the association with hematoma volume and growth in patients with prior antiplatelet use.
Cerebral microbleeds increase the risk for symptomatic ICH after thrombolysis for acute ischemic stroke.
Lower serum calcium levels correlate with risk of hematoma expansion in intracerebral hemorrhage.
Risk factors differ for early vs late-onset dementia after ICH.
A joint medical and surgical approach may ensure the best outcome.
Neurology Advisor Articles
- High-Dose Biotin May Be an Effective Treatment for Progressive MS
- Biobank Data Suggest Vitamin D Reduces Risk for Multiple Sclerosis
- Patients With Multiple Sclerosis Face Greater Infection Risk
- Fingolimod Compared With Glatiramer Acetate in Head-to-Head MS Study
- Lower Relapse Risk and Disability Progression With Oral DMT in Treatment-Naive RRMS
- Anodal tDCS Offers Possible Benefit for Improving Item Recall in Post-Stroke Aphasia
- Hospitalization Tied to Brain Abnormalities in Older Adults
- Spending Often Persists in High-Cost Medicare-Medicaid Eligible
- Skills-Based Intervention Did Not Cut Systolic BP After Stroke, TIA
- High Frequency of Headaches Following Dialysis Associated With BUN and Blood Pressure