Brain Hemorrhages最新文献

{"title":"Simultaneous bilateral basal ganglia hemorrhage: case report and literature review","authors":"Ryoma Watanabe ,&nbsp;Jin Kikuchi ,&nbsp;Yu Hasegawa ,&nbsp;Makoto Hoshino ,&nbsp;Kimihiko Orito ,&nbsp;Masaru Hirohata ,&nbsp;Motohiro Morioka","doi":"10.1016/j.hest.2025.05.002","DOIUrl":"10.1016/j.hest.2025.05.002","url":null,"abstract":"<div><h3>Objective</h3><div>To present a rare case of symmetric hemorrhages in the bilateral basal ganglia with unique imaging findings and discuss potential pathophysiological mechanisms.</div></div><div><h3>Case presentation</h3><div>A 78-year-old woman with untreated hypertension experienced sudden onset of consciousness disturbance (Glasgow Coma Scale E1V1M2 score on admission) with a decerebrate posture. Head computed tomography (CT) revealed symmetric hemorrhages in the bilateral basal ganglia and acute hydrocephalus. Contrast-enhanced CT at the hyperacute stage showed bilateral contrast medium leakage in the early and delayed phases. The patient was transferred to a rehabilitation hospital with severe abulia after 60 days following bilateral ventricular drainage and blood pressure control. Several studies report bilateral basal ganglia hemorrhage, and some hypotheses regarding the underlying mechanisms have been suggested. However, its precise cause remains unclear.</div></div><div><h3>Conclusion</h3><div>This report is the first to demonstrate bilateral contrast medium leakage in the basal ganglia, which suggests simultaneous bilateral small vessel disruption.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 1","pages":"Pages 68-74"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147620694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of PGC-1α in brain injury: mechanisms and therapeutic potential","authors":"Xinyi Dai ,&nbsp;Wenlu Song ,&nbsp;Jiayi Wu ,&nbsp;Shaojie Gao ,&nbsp;Lin Liu ,&nbsp;Hong Wu ,&nbsp;Longqing Zhang ,&nbsp;Daiqiang Liu ,&nbsp;Yaqun Zhou ,&nbsp;Yingxin Tang ,&nbsp;Wei Mei","doi":"10.1016/j.hest.2025.07.006","DOIUrl":"10.1016/j.hest.2025.07.006","url":null,"abstract":"<div><div>Brain injury remains a significant contributor to mortality and long-term neurological disability worldwide, despite ongoing research efforts to develop effective therapies that can mitigate secondary damage. One promising therapeutic target is peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), a crucial regulator of mitochondrial homeostasis, antioxidant defense, and metabolic adaptation. This review explores the multifaceted roles of PGC-1α in various types of brain injuries, including traumatic, ischemic, and hemorrhagic injuries. In traumatic brain injury, PGC-1α has been found to play a pivotal role in reducing mitochondrial dysfunction and neuroinflammation. By promoting oxidative phosphorylation and inhibiting microglial activation, PGC-1α helps to preserve neuronal health and function. In ischemic brain injury, PGC-1α’s ability to restore energy metabolism through fatty acid oxidation and enhance antioxidant defenses against oxidative stress is particularly noteworthy. These actions contribute to improving neuronal survival and functional recovery. Similarly, in hemorrhagic brain injury, PGC-1α has demonstrated its protective effects by regulating lipid metabolism and inflammatory cascades. This helps to alleviate blood–brain barrier disruption and iron-induced oxidative damage, which are critical factors in the pathogenesis of this type of injury. Overall, these findings highlight the broad therapeutic potential of PGC-1α in brain injury. Furthermore, recent research has focused on developing pharmacological PGC-1α activators which have shown promise in pre-clinical models by restoring mitochondrial integrity and enhancing cellular resilience. In conclusion, the diverse roles of PGC-1α in traumatic, ischemic, and hemorrhagic brain injuries, as well as its spatiotemporal regulatory mechanisms, provide valuable insights into its therapeutic potential. As research continues to advance, PGC-1α-based strategies hold promise as innovative therapeutic approaches for brain injury, offering new hope for patients worldwide.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 1","pages":"Pages 38-48"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147620737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated network pharmacology reveals the mechanisms of punicalagin in cardiovascular and cerebrovascular diseases treatment","authors":"Jieru Yang ,&nbsp;Lihan Zhang ,&nbsp;Jiasen Ye ,&nbsp;Ruicheng Yan ,&nbsp;Xiancheng Qiu ,&nbsp;Lifang Zhang ,&nbsp;Yong Jiang ,&nbsp;Jianhua Peng","doi":"10.1016/j.hest.2025.06.001","DOIUrl":"10.1016/j.hest.2025.06.001","url":null,"abstract":"<div><h3>Objective</h3><div>Cardiovascular and cerebrovascular diseases, including coronary artery disease (CAD), myocardial infarction (MI), carotid atherosclerosis (CAS), and cerebral ischemic stroke (CIS), continue to impose a significant global health burden due to the limited therapeutic efficacy of current clinical interventions. Punicalagin (PU), a pomegranate-derived polyphenol with antioxidant and anti-inflammatory properties, exhibits therapeutic potential but requires mechanistic clarification.</div></div><div><h3>Methods</h3><div>This study employed integrated network pharmacology, molecular docking, and experimental validation to identify PU’s multi-target mechanisms.</div></div><div><h3>Results</h3><div>PU has 519 potential targets and shares 185 common targets with CAD, MI, CAS, and CIS. Molecular docking analysis showed that PU had strong binding affinity with HIF-1α, CASPASE3 and TLR4 targets. Experimental validation using the OGD/R model in HT22 cells revealed that PU treatment significantly reduced reactive oxygen species (ROS) levels and apoptosis, while downregulating the expression of HIF-1α, CASPASE3 and TLR4. PU plays a critical role in cardiovascular and cerebrovascular diseases through the modulation of pathways associated with HIF-1α, CASPASE3 and TLR4.</div></div><div><h3>Conclusion</h3><div>Our study revealed the therapeutic effects and underlying mechanisms of PU on CAD, MI, CAS, and CIS, providing a foundation for subsequent <em>in vivo</em> and clinical studies on PU as a potential therapeutic agent.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 1","pages":"Pages 7-19"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147620696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atrous-based CBAM-Unet framework for intracranial hemorrhage segmentation and volume calculation with grading using CT images","authors":"S. Nafees Ahmed,&nbsp;P. Prakasam","doi":"10.1016/j.hest.2025.08.006","DOIUrl":"10.1016/j.hest.2025.08.006","url":null,"abstract":"<div><h3>Objective</h3><div>Intracranial hemorrhage (ICH) is a leading cause of death following trauma, often resulting from traumatic brain injury (TBI) when not promptly evaluated and treated within the first 24 hours. Quantitative assessments—such as hemorrhage thickness, volume, and grading—are essential for prognosis but are frequently unavailable. This study aims to develop a reliable segmentation method for ICH to enable accurate volumetric measurement and grading.</div></div><div><h3>Methods</h3><div>We propose an Atrous-based Convolution Block Attention Module (CBAM) Unet for precise feature extraction and robust segmentation of hemorrhagic lesions. The model enhances feature representation through atrous convolutions and attention mechanisms. Hemorrhage volume was subsequently calculated using a pixel-based method. Performance was evaluated using segmentation metrics, classification accuracy, and intraclass correlation coefficient (ICC) for volume measurement reliability.</div></div><div><h3>Results</h3><div>The proposed method achieved a Dice coefficient of 91.67 and an IoU of 84.62 for hemorrhage segmentation, along with 100% classification accuracy. Volumetric assessment for ICH grading demonstrated excellent reliability, with an ICC of 0.997 and a 95% confidence interval ranging from 0.98 to 1.00, indicating a very high upper bound and strong dependability.</div></div><div><h3>Conclusion</h3><div>The Atrous-based CBAM-Unet effectively segments intracranial hemorrhages and provides highly reliable volumetric measurements. Its strong performance in both segmentation accuracy and volume estimation supports its potential for clinical application in ICH grading and prognostic evaluation.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 1","pages":"Pages 20-37"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147620697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress on risk stratification warning models for early hematoma expansion and poor outcome in intracerebral hemorrhage: A narrative review","authors":"Shuqiang Zhang ,&nbsp;Tao Jiang ,&nbsp;Keqiong Yan ,&nbsp;Yanling Zhang ,&nbsp;Xiao Hu ,&nbsp;Xiaoyan Tang ,&nbsp;Wensong Yang ,&nbsp;Peng Xie","doi":"10.1016/j.hest.2025.11.004","DOIUrl":"10.1016/j.hest.2025.11.004","url":null,"abstract":"<div><h3>Objective</h3><div>This review explores recent advances in risk stratification systems for early hematoma expansion (HE), focusing on predictive models using CTA, NCCT, radiomics, and artificial intelligence to enhance accuracy and clinical utility. The study analyzes literature on CTA spot signs, NCCT imaging features, and radiomics combined with machine learning for hematoma expansion prediction. It compares traditional biomarkers with artificial intelligence-driven models.</div></div><div><h3>Methods</h3><div>A narrative review was performed to synthesize the available literature and explore the predictive value of CTA spot signs, NCCT imaging features, and radiomics combined with machine learning for hematoma expansion and outcomes.</div></div><div><h3>Results</h3><div>Integrating multimodal imaging and artificial intelligence significantly enhances HE prediction. Future work should focus on multicenter validation and standardized models to optimize personalized treatment and improve intracerebral hemorrhage outcomes.</div></div><div><h3>Conclusion</h3><div>Intelligent risk stratification systems, incorporating multimodal imaging and artificial intelligence, enhance hematoma expansion prediction and clinical utility. Future research could prioritize multicenter validation, standardization of models, and the development of personalized treatment strategies to ultimately improve outcomes for ICH patients.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 1","pages":"Pages 49-55"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147620738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"mGluR1 characteristic in cerebrospinal fluid of patients with aneurysmal subarachnoid hemorrhage","authors":"Weiqi Wang ,&nbsp;Mengna Zhu ,&nbsp;Haiguang Lv ,&nbsp;Qiang Zong ,&nbsp;Zongyong Zhang","doi":"10.1016/j.hest.2025.02.005","DOIUrl":"10.1016/j.hest.2025.02.005","url":null,"abstract":"<div><h3>Objective</h3><div>Glutamate receptor-mediated excitotoxicity plays crucial role in aneurysmal subarachnoid hemorrhage (aSAH). Truncation of metabotropic glutamate receptor 1 (mGluR1) is a key step in excitotoxicity, whether it occurs in aSAH patients is unclear. This study attempts to investigate mGluR1 characteristic in cerebrospinal fluid (CSF) of aSAH patients.</div></div><div><h3>Methods</h3><div>CSF samples from normal pressure hydrocephalus (NPH) and aSAH patients were obtained via the external ventricular drainage, collected by centrifugation, and stored at −80℃ until analyze by Western Blot and Enzyme-linked Immunosorbent Assay (ELISA). The clinical and hemorrhage severity (Hunt and Hess, HH grade; World Federation of Neurological Surgeons, WFNS grade; Fisher grade), and clinical outcome (Glasgow outcome scale, GOS) were retrieved from aSAH patients’ records.</div></div><div><h3>Results</h3><div>In the early exploration phase (3 aSAH vs 3 NPH), Western blot analysis of CSF samples showed that the protein band detected with the anti-mGluR1_300-400 antibody is 95 kDa, while that detected with the anti-mGluR1_1159-1171 antibody is 38 kDa, indicating that truncation of mGluR1 occurred in CSF of aSAH patients, but not observed in CSF of control patients. The semi-quantitative analysis of mGluR1 protein band (38 and 95 kDa) and the ELISA measured mGluR1 level show a similar trend of change. Next, the mGluR1 level in CSF of 244 aSAH patients was determined by ELISA analysis. Initial level of mGluR1 was significantly higher in aSAH patients with Fisher score of 3–4 versus 1–2, WFNS grade of IV-V versus I-III, HH grade of IV-V versus I-III, and with GOS score of 1–3 (poor outcome) versus 4–5 (good outcome). The multivariable logistic regression analysis showed that initial level of mGluR1 was associated with the occurrence of poor outcome, resulted in an area under receiver-operator characteristic curve (ROC) of 0.837 in predicting poor outcome.</div></div><div><h3>Conclusion</h3><div>These findings indicate that early high level of mGluR1 truncation in CSF could serve as a potential predictor of poor outcome in aSAH patients.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 1","pages":"Pages 1-6"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147620695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pituitary apoplexy following heart surgery: a comprehensive review of the literature","authors":"Theofilos Kanavos ,&nbsp;Effrosyni Birbas ,&nbsp;Maria Georgiadou ,&nbsp;Nikolaos Tsaftaridis","doi":"10.1016/j.hest.2025.09.004","DOIUrl":"10.1016/j.hest.2025.09.004","url":null,"abstract":"<div><div>Pituitary apoplexy (PA) is a clinical syndrome characterized by abrupt infarction or hemorrhage of the hypophysis, typically within a pituitary adenoma. Heart surgery, particularly with the use of cardiopulmonary bypass, has emerged as a significant precipitating factor for PA with 45 cases reported to date. The pathogenesis of PA in this setting is multifactorial and involves a complex interplay between factors related to the surgical procedure and the underlying tumor itself. This rare but potentially sight- and even life-threatening neuroendocrine emergency should be suspected in any patient presenting with sudden neuro-ophthalmological impairment accompanied by headache after a cardiac operation. PA as a complication of heart surgery predominantly affects men in their sixth or seventh decade of life and most commonly manifests in the early postoperative period. Although PA associated with cardiac surgery generally carries a favorable prognosis, it remains a severe condition with potential for poor outcomes. Awareness of the risk of PA after heart surgery, heightened clinical vigilance in the perioperative period, and familiarity with its clinical, radiological, and laboratory characteristics are crucial for prompt diagnosis and appropriate management by a multidisciplinary team, thereby reducing the risk of irreversible neuro-ophthalmic and endocrine dysfunction and death.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 1","pages":"Pages 56-67"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147620739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting mitochondrial NOX4/ROS to prevent hyperglycemia-induced hemorrhagic transformation after mechanical thrombectomy in acute ischemic stroke","authors":"Wensong Su ,&nbsp;Xiaoqiong Su ,&nbsp;Xuxiang Yu ,&nbsp;Guijiang Dong ,&nbsp;Junjiang Tong ,&nbsp;Xinhua Tian ,&nbsp;Zhong Liu","doi":"10.1016/j.hest.2025.11.002","DOIUrl":"10.1016/j.hest.2025.11.002","url":null,"abstract":"<div><h3>Objective</h3><div>This study examines whether mitochondrial NOX4 (mtNOX4) plays a crucial role in hemorrhagic transformation (HT) after mechanical thrombectomy (MT) in acute ischemic stroke (AIS).</div></div><div><h3>Methods</h3><div>The rat hyperglycemia-induced HT model and brain microvascular endothelial cells OGD/R model were used to simulate the process of HT after MT in human AIS. NOX4 siRNA induced NOX4 knockdown <em>in vitro</em> or NOX4 shRNA <em>in vivo</em>. MtNOX4/ROS was measured <em>in vivo</em> and <em>in vitro</em>. <em>In vitro</em>, tight junction (TJ) proteins and adhering junction (AJ) proteins were detected in endothelial cells. Infarct volume, HT, BBB damage, and neurological score were determined 24 h after cerebral ischemia <em>in vivo</em>.</div></div><div><h3>Results</h3><div>The induction of mitochondrial oxidative stress by mtNOX4/ROS disrupted AJ and TJ proteins after OGD/R. Furthermore, compared to the OGD/R group, NOX4 siRNA decreased the expression of mtNOX4/ROS and mitigated the downregulation of ZO-1, Occludin, Claudin-5, and VE-Cadherin. <em>In vivo</em> experiments demonstrated that NOX4 knockdown suppressed mtNOX4/ROS upregulation in the penumbra area compared to the HT group. Additionally, NOX4 knockdown reduced infarct volume and HT while improving BBB integrity and neurological outcomes.</div></div><div><h3>Conclusion</h3><div>Targeting the mtNOX4/ROS pathway may be a potential treatment strategy to improve outcomes in patients suffering from HT after MT for AIS.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 6","pages":"Pages 277-284"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IRRAflow active irrigation and drainage system: A glimpse into the future of cerebrospinal fluid shunts","authors":"Saif D. Salman ,&nbsp;Rabih G. Tawk ,&nbsp;Krishnan Ravindran ,&nbsp;Daniel A. Tonetti ,&nbsp;Nicholas Brandmeir ,&nbsp;Behnam Rezai Jahromi ,&nbsp;Babak Jahromi ,&nbsp;Richard W. Byrne ,&nbsp;William D. Freeman","doi":"10.1016/j.hest.2025.10.002","DOIUrl":"10.1016/j.hest.2025.10.002","url":null,"abstract":"<div><div>Chronic hydrocephalus after subarachnoid hemorrhage may become inevitable, necessitating a permanent cerebrospinal fluid shunt. We report a 40-year-old woman with SAH and a CHESS score of 6. We implemented the IRRAflow active irrigation and drainage system which expedited hemorrhage clearance in 4 days compared to one or two weeks longer with standard external ventricular drains. This system reduced the inflammatory load and preserved the arachnoid granulations, which are responsible for CSF resorption. Further, expedited recanalization of the fourth ventricle prevented an exponential increase in intracranial pressure. Collectively, these factors prevented CSF shunt dependency.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 6","pages":"Pages 339-342"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of body-mass-index on functional outcomes and bleeding volumes in patients suffering spontaneous intracerebral haemorrhage","authors":"Stefan Wanderer ,&nbsp;Attill Saemann ,&nbsp;Joshua Haegler ,&nbsp;Basil E. Grüter ,&nbsp;Julian Muff ,&nbsp;Sivani Sivanrupan ,&nbsp;Donato D’Alonzo ,&nbsp;Miriam Weiss ,&nbsp;Angelo Tortora ,&nbsp;Christian Musahl ,&nbsp;Gerrit Alexander Schubert ,&nbsp;Serge Marbacher ,&nbsp;Lukas Andereggen","doi":"10.1016/j.hest.2025.06.002","DOIUrl":"10.1016/j.hest.2025.06.002","url":null,"abstract":"<div><h3>Objective</h3><div>The association between obesity and clinical as well as radiological outcomes in patients suffering spontaneous intracerebral haemorrhage (ICH) remains unclear. The obesity paradox suggests a protective effect regarding in-hospital mortality. This study evaluates the impact of body mass index (BMI) on functional long-term outcome and bleeding volume in patients with spontaneous ICH.</div></div><div><h3>Methods</h3><div>A retrospective cohort study including all patients with spontaneous ICH between December 2017 and June 2021, aged 80 years or younger (<em>n</em> = 218), were included. Patients were dichotomized into overweight (OW, BMI ≥ 25 kg/m²) and normal weight (NW, BMI &lt; 25 kg/m²). Functional outcomes were assessed at 1, 3, 6 and 12-months follow-up. To address potential sex-related bias, we conducted exploratory post hoc analyses.</div></div><div><h3>Results</h3><div>Of 218 patients (66.04 ± 15.18 years) suffering spontaneous ICH, 115 (52.75 %) were OW (29.72 ± 3.82). Multivariate analysis revealed that independent significant predictors of a favourable 12-month functional outcome were smaller haematoma volume (<em>p</em> = 0.01) and symptom onset less than 6 h before arrival at our hospital (<em>p</em> = 0.018), whereas BMI was not, whether analysed dichotomously, continuously, or by WHO categories (<em>p</em> ≥ 0.41). Younger age showed to be a significant predictive factor for a better 12-month outcome in univariate analyses (<em>p</em> = 0.003), but lost significance in multivariate analyses (<em>p</em> = 0.14). Sex distribution (<em>n</em> = 72 females, <em>n</em> = 68 males; <em>p</em> = 1.0), NIHSS at admission (<em>p</em> = 0.69) and overweight prevalence (41.7 % vs. 55.9 %; <em>p</em> = 0.13) did not differ significantly between groups. Stratified BMI-outcome associations remained non-significant in both sexes (<em>p</em> = 0.39 for males, <em>p</em> = 0.21 for females).</div></div><div><h3>Conclusion</h3><div>Our data suggests that in patients suffering from spontaneous ICH, haematoma volume and age, are independent negative predictors for functional outcome in the long-term. BMI was not associated with 12-month outcome after adjustment, while early presentation (within 6 h of symptom onset) predicted favourable 12-month outcome.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 6","pages":"Pages 293-300"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}