Brain Hemorrhages最新文献

{"title":"Oxidative stress in post-stroke neurorestoration: from mechanisms to therapy","authors":"Pingping Guo, Lingxiao Qi, Voon Wee Yong, Mengzhou Xue","doi":"10.1016/j.hest.2026.03.007","DOIUrl":"10.1016/j.hest.2026.03.007","url":null,"abstract":"","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 4","pages":"Pages 205-207"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148806553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning-based radiomics model for predicting hematoma enlargement in spontaneous intracerebral hemorrhage: A multicenter study","authors":"Jianlong Ouyang,&nbsp;Wei Xu,&nbsp;Xianting Luo,&nbsp;Xiaoping Yin,&nbsp;Yuyuan Zhou,&nbsp;Liang Chen,&nbsp;Jiayu Yin,&nbsp;Zhiyin Chen","doi":"10.1016/j.hest.2025.09.001","DOIUrl":"10.1016/j.hest.2025.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to establish and validate three predictive models: a clinical model (CM), a radiomics model (RM), and a combined clinical–radiomics model (CRM) for forecasting hematoma progression in patients with spontaneous intracerebral hemorrhage (sICH) within 24 h of admission.</div></div><div><h3>Methods</h3><div>A total of 477 patients were included in the training cohort (TC), while 106 patients were assigned to the validation cohort (VC). For the RM, radiomics features were first extracted, and the Least Absolute Shrinkage and Selection Operator (LASSO) regression was applied to identify the most relevant predictors. Ten different machine-learning algorithms were evaluated to determine the optimal model. The CM was developed using univariate and multivariate logistic regression analyses to identify independent clinical risk factors for hematoma expansion. The CRM was then constructed by integrating both CM and RM features.</div></div><div><h3>Results</h3><div>Nine radiomics features were ultimately selected, and the Extra Trees algorithm was applied to build the RM. Independent clinical predictors of hematoma expansion included diabetes, the presence of the whirlpool sign, CT attenuation value, and baseline hematoma volume. In the TC, the area under the receiver operating characteristic curve (AUC) values for the CRM, RM, and CM were 0.901, 0.892, and 0.821, respectively. In the VC, the corresponding AUC values were 0.797, 0.780, and 0.786.</div></div><div><h3>Conclusion</h3><div>The CRM demonstrated superior predictive performance compared to the individual CM and RM, offering a reliable tool for early identification of hematoma enlargement in patients with sICH.</div></div><div><h3>Funding</h3><div>This work is funded by the Science and Technology Bureau of Jiujiang (Grant No. S2024ZDYFN0059), Jiangxi Provincial Health Commission (Grant No. SKJP1220242116).</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 4","pages":"Pages 215-224"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148806682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of an improved ICH score: Integrating clinical and radiographic parameters for enhanced prediction of 30-day mortality in spontaneous intracerebral hemorrhage","authors":"Pichayen Duangthongphon,&nbsp;Amnat Kitkhuandee,&nbsp;Pornthep Kasemsiri,&nbsp;Phumtham Limwattananon,&nbsp;Anuchit Phankhongsab","doi":"10.1016/j.hest.2025.02.004","DOIUrl":"10.1016/j.hest.2025.02.004","url":null,"abstract":"<div><h3>Objective</h3><div>The ICH score effectively predicts 30-day mortality in patients with intracerebral hemorrhage (ICH), but accuracy decreases in surgical cases. This study evaluated whether integrating clinical and radiographic parameters with the original ICH variables enhances mortality prediction.</div></div><div><h3>Methods</h3><div>This study reviewed charts of 368 adults with spontaneous ICH from 2014 to 2019. Stepwise logistic regression and multivariate analysis were employed to identify additional clinical parameters associated with 30-day mortality. A scoring system was developed using significantly linked factors (<em>p</em> &lt; 0.05) and evaluated for predictive performance using the area under the receiver operating characteristic curve (AUROC).</div></div><div><h3>Results</h3><div>Among the 368 patients, 104 (28.3 %) died within 30 days. Five variables were assigned score weights: pupil status, warfarin use, infratentorial location, Glasgow Coma Scale (GCS) score, and hematoma volume &gt;30 mL, identified as independent risk factors. The new scoring system improved the AUROC to 0.91 in the internal validation cohort, up from 0.87 for the original ICH score. For surgical patients, AUROC values were 0.69 and 0.57, respectively.</div></div><div><h3>Conclusion</h3><div>Incorporating pupil status and warfarin use with the three ICH score parameters enhances mortality prediction in all patient cohorts, including those undergoing surgical intervention.</div></div><div><h3>Funding</h3><div>This work was supported by the Faculty of Medicine, Khon Kaen University (Grant number IN63334).</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 4","pages":"Pages 208-214"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148806681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of middle meningeal artery embolization in combination with burr hole craniostomy for chronic subdural hematomas: A single-center experience","authors":"Jiandong Wu,&nbsp;Peng Deng,&nbsp;Jinhong Qian,&nbsp;Zhiliang Ding,&nbsp;Mian Ma,&nbsp;Xiaoyu Tang","doi":"10.1016/j.hest.2024.10.004","DOIUrl":"10.1016/j.hest.2024.10.004","url":null,"abstract":"<div><h3>Background and Objective</h3><div>Chronic subdural hematoma (CSDH) is a prevalent neurosurgical condition. The mass effect of hematoma could lead to a series of neurological dysfunctions. Surgical intervention, such as burr hole craniostomy (BHC), is often recommended due to persistent symptoms, but recurrence rates remain significant. Middle meningeal artery embolization (MMAE) is a promising treatment strategy for CSDH, this study aims to evaluate the efficacy and safety of MMAE in combination with BHC for managing CSDH.</div></div><div><h3>Methods</h3><div>A comparative analysis was conducted on 101 patients (harboring 123 CSDHs) who underwent either burr hole craniostomy alone or combined therapy with burr hole craniostomy and MMAE. Data on demographic information, clinical characteristics, treatment modalities, and outcomes were collected and analyzed.</div></div><div><h3>Results</h3><div>Combined therapy with burr hole craniostomy and MMAE resulted in lower recurrence rates compared to burr hole craniostomy alone. Complication rates were similar between groups, and MMAE was technically successful in all cases. Patients in the combined therapy group showed an improved GOS score at the predefined 6-month follow-up.</div></div><div><h3>Conclusion</h3><div>Middle meningeal artery embolization, when combined with burr hole craniostomy, represents a safe and effective approach for managing CSDH, resulting in reduced recurrence rates and improved short-term outcomes.</div></div><div><h3>Funding</h3><div>This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 4","pages":"Pages 225-230"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148806678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-port robot-assistant visualized minimally invasive aspiration (RAVMIA) for evacuation of irregular basal ganglia hemorrhage: A technical note","authors":"Huachao Li,&nbsp;Zhenyu Luo,&nbsp;Tingzhong Wang","doi":"10.1016/j.hest.2026.03.004","DOIUrl":"10.1016/j.hest.2026.03.004","url":null,"abstract":"<div><h3>Background</h3><div>The surgical management of intracerebral hemorrhage (ICH) remains controversial. While minimally invasive endoscopic techniques have shown promise, recent trials have not demonstrated positive outcomes for deep-seated basal ganglia hemorrhages. Although we previously reported a novel robot-assisted visualized minimally invasive aspiration (RAVMIA) technique effective for oblong hematomas, irregularly shaped or massive basal ganglia hemorrhages continue to pose a significant clinical challenge.</div></div><div><h3>Methods</h3><div>We applied a dual-port RAVMIA technique in a case of irregular basal ganglia hemorrhage. The hematoma was morphologically deconstructed into two ellipsoids. Using robotic planning, two surgical trajectories were designed along their long axes. Two 5-mm trocars were inserted along these trajectories, and a contact-visible endoscope was used for real-time monitoring of the aspiration process.</div></div><div><h3>Results</h3><div>The procedure was successfully completed without complications. The total brain parenchymal injury measured 1 cm (comprising two 5-mm tracts). A 92.9% hematoma evacuation rate was achieved within 25 min. Postoperatively, the patient showed improvement in neurological function.</div></div><div><h3>Conclusion</h3><div>This preliminary technical report demonstrates the potential applicability of the dual-port RAVMIA technique in a single case of irregular basal ganglia hemorrhage. Further studies with larger cohorts are warranted to evaluate its safety, efficacy, and generalizability.</div></div><div><h3>Funding</h3><div>This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 4","pages":"Pages 238-243"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148806680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reversible cerebral vasoconstriction syndrome: not just a “reversible” condition. Retrospective observational study and literature review","authors":"Joumana Freiha,&nbsp;Ardalan Zolnourian,&nbsp;Aung Oo,&nbsp;Srihari Deepak,&nbsp;Chinar Osman","doi":"10.1016/j.hest.2025.09.003","DOIUrl":"10.1016/j.hest.2025.09.003","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aims to critically evaluate the evolving understanding of reversible cerebral vasoconstriction syndrome (RCVS) by examining its potential for long-term complications. While reversible cerebral vasoconstriction syndrome (RCVS) is traditionally recognised as a monophasic self-limiting condition, characterised by transient cerebral vasospasm, severe thunderclap headaches, and reversible cerebral vasoconstriction. However, recent evidence challenges this characterisation, revealing that the syndrome is neither universally self-limiting nor fully reversible. By analysing outcomes beyond the acute phase, this review seeks to redefine the prognostic spectrum of RCVS.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of RCVS cases over a 10-year period. A total of 97 cases were found, 28 cases were excluded due to change in diagnosis and a further 39 cases were also excluded as they did not fit the diagnostic criteria. The final patient cohort consisted of 30 patients.</div></div><div><h3>Results</h3><div>Our review revealed a 27 % long term complication rate, including ischemic/haemorrhagic strokes (n = 3), persistent neurocognitive dysfunction (n = 2), chronic daily headaches (n = 1), and late-onset epilepsy (n = 2). Identified triggers included vasoactive agents, stress, and physical exertion. Nimodipine, which is commonly used as treatment, was associated with symptomatic relief but did not consistently prevent complications.</div></div><div><h3>Conclusion</h3><div>Our complication rate (27%) echoed the reported complication rates in the current literature (21%) for RCVS which challenge the traditional view and definition of RCVS as a self-limiting condition. The persistence of complications, including cognitive deficits and chronic pain, underscores the impact on patients’ quality of life and functional outcomes. Our review highlights the need for recognising clinical urgency, early diagnostic measures, and standardised treatment protocols. Further research is essential to explore the underlying pathophysiology, optimise therapeutic interventions, and evaluate the potential benefits of prompt treatment in reducing long-term complications and improving outcomes for patients with RCVS.</div></div><div><h3>Funding</h3><div>This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 4","pages":"Pages 231-237"},"PeriodicalIF":2.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148806679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of pre-admission use of sartans and calcium channel antagonists with outcomes after spontaneous intracerebral hemorrhage: A retrospective cohort study","authors":"Stefan Wanderer,&nbsp;Joshua Haegler,&nbsp;Julian Louis Muff,&nbsp;Attill Saemann,&nbsp;Miriam Weiss,&nbsp;Basil Grüter,&nbsp;Serge Marbacher,&nbsp;Lukas Andereggen","doi":"10.1016/j.hest.2026.03.005","DOIUrl":"10.1016/j.hest.2026.03.005","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Spontaneous intracerebral hemorrhage (ICH) is a severe stroke subtype associated with high morbidity and mortality. Preclinical studies suggest that angiotensin II-type 1 receptor blockers such as sartans and calcium channel antagonists (CCAs) may confer neuroprotective effects in cerebrovascular disease through anti-inflammatory actions, improving microcirculation, and mitigating cerebral vasospasm. These effects were of particular interest in patients suffering subarachnoid hemorrhage (SAH). This study aimed to evaluate whether these medications confer similar benefits in patients with ICH.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We performed a retrospective single-center cohort study including 326 patients with spontaneous ICH between December 2017 and June 2021. The primary endpoint was functional independence (mRS 0–2 at 90 days); an exploratory ordinal mRS-shift analysis was additionally conducted. 155 patients with documented antihypertensive therapy were included and stratified into four groups: sartans (&lt;em&gt;n&lt;/em&gt; = 39), CCA (&lt;em&gt;n&lt;/em&gt; = 36), sartan + CCA (SC; &lt;em&gt;n&lt;/em&gt; = 17) and other antihypertensive medications (OAM; &lt;em&gt;n&lt;/em&gt; = 63). 171 patients had to be excluded due to missing antihypertensive drug data. Clinical and radiographic data (including 3D-volumetric ICH measurements) were collected. Hematoma volume was measured using volumetric imaging (Brainlab AG, Germany). Functional outcome was assessed via the modified Rankin Scale (mRS) at discharge and at 1-, 3-, 6-, and 12-month follow-up. The 1-month follow-up was performed in person, whereas the 3-, 6- and 12-month follow-up were obtained via structured telephone interviews. Group differences were analyzed using chi-square/Fisher’s tests and ANOVA/Kruskal-Wallis tests as appropriate (two sided &lt;em&gt;P&lt;/em&gt; &lt; 0.05).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Groups were similar in age, sex, admission GCS, NIHSS, blood pressure, ICH location, and initial hemorrhage volume. The only significant baseline difference was BMI: the sartan group had a significantly higher BMI than the CCA and OAM groups (overall &lt;em&gt;P&lt;/em&gt; = 0.039; &lt;em&gt;post-hoc P&lt;/em&gt; = 0.028 and &lt;em&gt;P&lt;/em&gt; = 0.019, respectively). There was no significant difference in the proportion of patients achieving functional independence (mRS 0–2) at any follow-up, nor in the ordinal mRS-shift analysis and no trend toward improved outcomes in patients on sartans or CCAs. Sartans were administered to 39 patients (25.2%), CCA to 36 (23.2%), both combined to 17 (11.0%), and OAM to 63 (40.6%). Functional outcomes at all follow-up intervals showed no significant variation among the groups.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Our study did not demonstrate a neuroprotective effect of sartans or CCAs resulting in improved functional outcomes after ICH. The limited sample size, especially in the group with combined use of sartan and CCA (&lt;em&gt;n&lt;/em&gt; = 17) and the retrospective design, limit causal inference. Whil","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 3","pages":"Pages 153-159"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148571967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Precision medicine for cerebral Haemorrhage: Integrating Neuromarkers, Therapeutics, and recovery pathways","authors":"Prabakaran Sankar,&nbsp;Mayuricca Siva Ramya Mohana,&nbsp;Karthikeyan Elumalai","doi":"10.1016/j.hest.2026.03.001","DOIUrl":"10.1016/j.hest.2026.03.001","url":null,"abstract":"<div><div>Intracerebral hemorrhage (ICH) is one of the most devastating and disabling forms of stroke, and its outcome is predetermined not only by the volume and location of the hematoma but also by the development of secondary injury cascades, including disruption of the blood–brain barrier, neuroinflammation, oxidative stress, iron-mediated toxicity, and disintegration of the network. Multimodal neuromarkers, including structural and vascular imaging biomarkers, circulating injury and inflammatory biomarkers, and genetic and multi-omics risk stratifiers, are redefining risk assessment, biological phenotyping, and targeted therapy in all phases of hyperacute, subacute, and recovery stages of ICH. Nevertheless, translational maturity differs significantly. Clinically actionable metrics, that is, imaging-derived metrics and hemostatic parameters, are workflow-integrated and geographically local, but most molecular, mechanistic, and computational biomarkers are investigation-oriented and often add to but do not directly aid bedside decision-making. This review presents the biomarker picture as a series of stages of clinical decision-making to hyperacute stabilization, secondary injury modulation, neurorecovery optimization, and recurrence prevention. We critically evaluated the evidence hierarchy, gaps in external validation, assay standardization issues, and clinical implementation barriers that have restricted therapeutic success in ICH. The combination of multimodal neuromarkers in a decision-oriented pathway to precision enables us to map the way to apply biological understanding to outcome-altering and patient-specific care.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 3","pages":"Pages 137-152"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148299784","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 TLR4/MyD88 axis: Orchestrator of neuroinflammation from molecular initiation to systemic crosstalk","authors":"Wenjun Pi,&nbsp;Liang Cao,&nbsp;Qingli Wang,&nbsp;V.Wee Yong,&nbsp;Leiluo Yang,&nbsp;Mengzhou Xue","doi":"10.1016/j.hest.2026.03.002","DOIUrl":"10.1016/j.hest.2026.03.002","url":null,"abstract":"<div><div>Neuroinflammation is a convergent feature of neurodegenerative diseases, hemorrhagic and ischemic stroke, and spinal cord injury. Central to this process is the Toll-like receptor 4 (TLR4) and myeloid differentiation primary response 88 (MyD88) signaling axis, which senses damage-associated molecular patterns to initiate innate immune responses. While the canonical inflammatory role of TLR4 is well-defined, recent evidence identifies it as a critical regulator of non-canonical cell death-including pyroptosis and necroptosis-and a requisite priming signal for NLRP3 inflammasome activation. This review examines the expanding complexity of TLR4/MyD88 signaling, moving beyond local central nervous system (CNS) activation to its regulation via the microbiota-gut-brain axis, metabolic endotoxemia, and epigenetic modifications such as miRNA and lncRNA networks. We synthesize these molecular insights within the context of specific pathologies, particularly Alzheimer’s disease, Parkinson’s disease, and traumatic CNS injury. Finally, we evaluate the translational potential of targeting this axis, highlighting the shift from broad-spectrum anti-inflammatories to precision strategies involving nanodelivery systems and immunometabolic modulation.</div><div>Funding: The authors’ research on cerebrovascular diseases was supported by grants from Henan Province Medical Science and Technology Research Program (SBGJ202403031); Postdoctoral Fellowship Program of China Postdoctoral Science Foundation (GZC20232401); Hunan Provincial Natural Science Foundation (2023JJ40572); National Natural Science Foundation of China (U25A2065, W2541024); Key Advantageous Discipline Construction Project of Guizhou Provincial Health Commission (2023, Emergency Department); Guizhou Provincial Natural Science Foundation (Qiankehe Foundation MS[2025]432); National Natural Science Foundation of China (NSFC) Regional Fund Cultivation Program Project of the Affiliated Hospital of Guizhou Medical University (gyfynsfc[2023]-47).</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 3","pages":"Pages 184-192"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148571965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress of peripheral inflammation in spontaneous cerebral hemorrhage","authors":"Yanghang Chen,&nbsp;Tianrui Yu,&nbsp;Fei kong,&nbsp;Tian xu,&nbsp;Changlin Xie,&nbsp;Ling He,&nbsp;Bing Bao,&nbsp;Zhiying Chen,&nbsp;Xiaoping Yin","doi":"10.1016/j.hest.2026.03.006","DOIUrl":"10.1016/j.hest.2026.03.006","url":null,"abstract":"<div><div>This review systematically summarizes the research progress on peripheral inflammation in spontaneous intracerebral hemorrhage (ICH), focusing on the interaction mechanisms of the “peripheral-central inflammation axis,” key biomarkers, and their clinical translational potential. After ICH, hematoma components (such as hemoglobin and thrombin) and damage-associated molecular patterns (DAMPs) disrupt the blood–brain barrier, activating peripheral immune cells (neutrophils, monocytes/macrophages, T cells, etc.) to migrate to the central nervous system, forming a “peripheral inflammation-central inflammation” positive feedback loop that exacerbates brain edema, hematoma expansion, and neurological deficits. Peripheral inflammatory cells mediate secondary damage by secreting pro-inflammatory cytokines (IL-1β, TNF-α, IL-6) and reactive oxygen species (ROS), while certain subpopulations (e.g., M2 macrophages, N2 neutrophils) participate in tissue repair. This article further summarizes the research progress on peripheral inflammation-related biomarkers in ICH, covering soluble serum factors (IL-6, IL-31, TNF-α, HMGB1, mCRP, etc.), acute-phase proteins (PCT, C3, C1q), and cell count ratios (NLR, PWR, SIRI), and highlights the potential application of single-cell sequencing technology in analyzing immune cell heterogeneity and dynamic evolution. In terms of interventions, this article reviews the efficacy and limitations of traditional anti-inflammatory drugs (NSAIDs, corticosteroids) and targeted inflammatory pathways (IL-1R antagonists, HMGB1 inhibitors, LPA1 antagonists, IL-4) in animal experiments and early clinical studies, and explores the potential value of non-pharmacological strategies such as the “gut-brain axis” and splenectomy. Future research should focus on elucidating the “peripheral-central” interaction mechanisms, multi-center biomarker validation, and the development of personalized anti-inflammatory intervention strategies to advance the clinical translation of ICH precision diagnosis and treatment.</div><div>Funding: This work was supported by the National Natural Science Foundation of China (81960221 to X.P.Y., 82,260,249 to X.P.Y.), Jiangxi Provincial Health Commission Science and Technology Plan project (202311506 to Z.Y.C.), Jiangxi Provincial Administration of Traditional Chinese Medicine science and technology plan project (2022A322 to Z.Y.C.), Jiangxi Provincial Natural Science Foundation Grant (20212BAB216069 to L.H.), Research and Reform Project on Education and Teaching in Ordinary Colleges and Universities of Jiangxi Province (JXJG-24-17-20 to Z.Y.C., JXYJG-2024-140 to X.P.Y.).</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 3","pages":"Pages 193-204"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148571966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}