Brain Hemorrhages最新文献

{"title":"Minimally invasive puncture and drainage combined with urokinase in the treatment of spontaneous intracerebral hemorrhage in the basal ganglia (MIPDU): A multicenter randomized controlled trial protocol","authors":"Chunsheng Xia,&nbsp;Anshuo Wang,&nbsp;Yuefan Yang,&nbsp;Xinyi Liu,&nbsp;Xiangpin Wei,&nbsp;Fei Wang,&nbsp;Hao Xu","doi":"10.1016/j.hest.2026.04.005","DOIUrl":"10.1016/j.hest.2026.04.005","url":null,"abstract":"<div><h3>Background</h3><div>Spontaneous intracerebral hemorrhage (ICH) represents a severe subtype of stroke with a notably high incidence, particularly in China, where it constitutes 21%–48% of cerebrovascular events. This condition predominantly affects the elderly population and is linked to high rates of mortality and disability. Key risk factors include hypertension, cerebral amyloid angiopathy, and the use of anticoagulants. Despite advancements in management strategies, such as blood pressure regulation and prevention of hematoma expansion, the treatment of ICH remains a formidable challenge. Minimally invasive puncture and drainage (MIPD) has demonstrated potential in enhancing patient outcomes by facilitating hematoma evacuation and reducing intracranial pressure. However, the results are still inconclusive, especially concerning hemorrhages in the basal ganglia.</div></div><div><h3>Objectives</h3><div>This study aims to evaluate the efficacy of combining MIPD with urokinase in comparison to conservative management for basal ganglia ICH.</div></div><div><h3>Study design</h3><div><strong>Method/Design:</strong> This multicenter, randomized controlled trial aims to assess the efficacy of minimally invasive puncture and drainage (MIPD) with urokinase compared to conservative management in patients with basal ganglia intracerebral hemorrhage (ICH) across ten neurosurgical centers in China.</div><div>Inclusion Criteria: The study will enroll 140 participants aged 18–80 years, who present with a Glasgow Coma Scale (GCS) score ranging from 4 to 14, a National Institutes of Health Stroke Scale (NIHSS) score of 6 or higher, and a hematoma volume between 20 and 40 mL.</div><div><strong>Randomization Method:</strong> All participants are randomly assigned to groups using the simple randomization method. Randomization will be stratified by center to ensure balanced distribution across sites.</div><div>Interventions: Participants in the intervention group will receive MIPD with urokinase within 48 h of symptom onset, while those in the control group will undergo conservative management.</div><div>Outcome Measures: The primary outcomes to be measured are mortality and functional disability, assessed using the GCS, modified Rankin Scale (mRS), and NIHSS, at 30 90 days and 180 days post-intervention. Secondary outcomes will include neurological recovery, rates of complications, and incidence of rebleeding.</div><div>Funding: This trial is supported in The National Natural Science Foundation of China (NSFC) Youth Project (NSFC-82101424) and Middleaged and Young Leading Talents in Scientific and Technical Innovation in Ankang (AK2023PD-ZQN-5).</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 3","pages":"Pages 160-167"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148571952","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":"Digital twins for stroke prediction and management","authors":"David B. Olawade","doi":"10.1016/j.hest.2026.04.002","DOIUrl":"10.1016/j.hest.2026.04.002","url":null,"abstract":"<div><h3>Background</h3><div>Stroke remains a leading global cause of mortality and disability, with optimal outcomes dependent on rapid risk identification, precise acute management, tailored interventions, and sustained rehabilitation. Digital twins, which are dynamic computational replicas of individual patients integrating multimodal data and mechanistic models, represent an innovative approach to simulating disease trajectories and treatment responses before real world implementation.</div></div><div><h3>Objective</h3><div>This narrative review synthesises current evidence on digital twin applications across the stroke care continuum, examining their role in risk prediction, acute decision support, clinical trial optimisation, intensive care monitoring, and personalised neurorehabilitation.</div></div><div><h3>Method</h3><div>We explored publications from PubMed, Nature Portfolio journals, IEEE and ACM databases spanning 2021 to 2025, identifying relevant publications across technical, clinical, and implementation dimensions. Search terms combined “digital twin” with stroke-specific and enabling-technology terminology. The review integrates findings across technical, clinical, and implementation dimensions to provide a holistic perspective on this rapidly evolving field.</div></div><div><h3>Results</h3><div>Emerging evidence demonstrates feasibility and early clinical utility of digital twins across multiple stroke phases. Applications include atrial fibrillation related embolic risk stratification through patient specific left atrial modelling, imaging informed cerebrovascular hemodynamics for acute triage, disease digital twin generators for trial enrichment, and robotic rehabilitation systems with adaptive learning. However, most studies remain at preclinical or early pilot stages, with few meeting strict real-time digital twin criteria requiring bidirectional data flow and continuous updating.</div></div><div><h3>Conclusion</h3><div>Digital twins offer transformative potential for stroke care through personalised risk assessment, hyperacute decision support, and adaptive rehabilitation. Translation to routine practice requires rigorous prospective validation, standardised data models, robust governance frameworks, and demonstrated clinical utility across diverse populations. A clear translational roadmap, from current component technologies to fully closed-loop systems, is essential to guide investment and prioritise research.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 3","pages":"Pages 168-183"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148571964","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":"Comparison of single-channel EEG decoding performance in imagined speech tasks","authors":"Xinyu Ma ,&nbsp;Yibo Ding ,&nbsp;Kunyuan Zhao ,&nbsp;Ping Zhang ,&nbsp;Yingxin Tang ,&nbsp;Jian Shi ,&nbsp;Danyang Chen ,&nbsp;Dongrui Wu ,&nbsp;Zhouping Tang","doi":"10.1016/j.hest.2026.01.001","DOIUrl":"10.1016/j.hest.2026.01.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Electroencephalography (EEG)-based imagined speech decoding technology offers a communication solution for patients with language impairments. However, existing research on English-language systems cannot be directly applied to Chinese due to significant linguistic differences. Multi-channel EEG systems face hardware complexity and computational delays. This study aimed to develop a single-channel EEG decoding system for Chinese imagined speech, explore neural mechanisms to promote low-cost rehabilitation devices.</div></div><div><h3>Methods</h3><div>EEG signals were recorded from four Chinese participants imagining five distinct Chinese characters. The SGLCNN model was proposed and compared with VGG16, EEGNet, and machine learning methods. Experiments evaluated the performance of 20 single-channel time–frequency graphs and compared their accuracy with traditional methods.</div></div><div><h3>Results</h3><div>The CP5 and C3 channels achieved the highest classification accuracies of 74.33% and 73%. The SGLCNN model outperformed EEGNet and VGG16 in decoding binary classification tasks for Chinese characters. Single-channel signals improved classification accuracy by 0.67% (SGLCNN) and 2.75% (EEGNet) compared to full-brain signals under the same models.</div></div><div><h3>Conclusion</h3><div>This is the first study to decode imagined Chinese speech using single-channel EEG and tests the performance of 20 channels for this task. The SGLCNN system maintains performance while reducing hardware needs. Identifying dominant channels (CP5/C3) informs clinical electrode placement, accelerating brain-computer interfaces (BCIs) translation.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 2","pages":"Pages 98-109"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147862804","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":"Perioperative management of brain hemorrhage: Advances in anesthetic strategies and translational medicine","authors":"Meenaloshini Gopalakrishnan ,&nbsp;Karthikeyan Elumalai ,&nbsp;Nandhini Jayaprakash","doi":"10.1016/j.hest.2025.07.004","DOIUrl":"10.1016/j.hest.2025.07.004","url":null,"abstract":"<div><div>Brain hemorrhage, which encompasses intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH), poses significant challenges in perioperative management. Despite advances in neurocritical care, patient outcomes remain suboptimal, emphasizing the need for optimized anesthetic strategies and translational research. This review explores the pathophysiology, preoperative assessment, anesthetic techniques, and postoperative management of patients with brain hemorrhage. The choice between general anesthesia and conscious sedation, along with the selection of anesthetic agents with neuroprotective properties, directly affects perioperative care. Advanced neuromonitoring, including intracranial pressure (ICP) and cerebral oxygenation monitoring, guides intraoperative decision-making. Postoperative complications such as rebleeding, vasospasm, and seizures require vigilant monitoring and management. Translational research has identified promising neuroprotective effects of anesthetic agents in animal models, but clinical translation remains a challenge. Regenerative medicine, including stem cell therapies and tissue engineering, offers potential for enhancing neuroplasticity and functional recovery which is still in the experimental stages. Personalized approaches, integrating genetic profiling, neuroimaging, and AI-driven decision support systems, may revolutionize future perioperative care. Multidisciplinary collaboration and innovative research are crucial for developing effective treatments and improving patient outcomes. Bridging the gap between preclinical findings and clinical practice remains essential for advancing perioperative management strategies in brain hemorrhage.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 2","pages":"Pages 110-125"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147862805","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":"Atorvastatin and glucocorticoid therapy for retroclival epidural hematoma: Case report and literature review","authors":"Chenrui Wu ,&nbsp;Tao Liu ,&nbsp;Ruichen Zhao ,&nbsp;Yu Tian ,&nbsp;Ji Cheng ,&nbsp;Rongcai Jiang","doi":"10.1016/j.hest.2025.03.002","DOIUrl":"10.1016/j.hest.2025.03.002","url":null,"abstract":"<div><div>Retroclival epidural hematomas (REDH) are particularly rare conditions. We report for the first time the effect of conservative treatment of this rare condition with atorvastatin and glucocorticoids and review the literature. In this case, atorvastatin and glucocorticoid therapy can promote hematoma absorption and symptom relief, providing a novel possibility for conservative treatment of REDH.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 2","pages":"Pages 132-136"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147862920","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":"Prognostic value of TC/HDL-C ratios in ischemic stroke: a multicenter observational study","authors":"Hang Ruan ,&nbsp;Qin Zhang ,&nbsp;Ping Zhang ,&nbsp;Yingxin Tang ,&nbsp;Xiao Ran","doi":"10.1016/j.hest.2026.01.003","DOIUrl":"10.1016/j.hest.2026.01.003","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to determine the relationship between the total cholesterol to high-density lipoprotein cholesterol (TC/HDL-C) ratio and adverse outcomes in patients with first-ever ischemic stroke (IS), and to validate its potential as a prognostic indicator.</div></div><div><h3>Methods</h3><div>A dual-cohort study integrating retrospective and prospective designs was conducted. The retrospective cohort included 45,162 patients with first-ever IS, and the prospective cohort comprised an independent sample of 2151 patients with first-ever IS. The primary outcome was a composite of stroke recurrence or all-cause death within five years. In the retrospective cohort, logistic regression and regression discontinuity design (RDD) were used to assess the relationship between TC/HDL-C ratio and adverse outcomes, adjusting for confounding factors (e.g., age, sex, comorbidities, and medication use). In the prospective cohort, logistic regression was employed to validate the association, with Kaplan-Meier survival analysis used to characterize prognosis across TC/HDL-C subgroups. Odds ratio (OR) and 95% confidence interval (CI) were calculated.</div></div><div><h3>Results</h3><div>In the retrospective cohort, a higher TC/HDL-C ratio was identified as an independent risk factor for Five-year adverse outcomes (univariate analysis: <em>OR</em> 1.35 (95% <em>CI</em>, 1.28–1.42), <em>P</em> &lt; 0.001; multivariate analysis: <em>OR</em> 1.30 (95% <em>CI</em>, 1.22–1.39), <em>P</em> &lt; 0.001), and this association was confirmed by RDD. In the prospective cohort, logistic regression replicated these findings, with each unit increase in TC/HDL-C associated with a 12% higher risk of adverse outcomes [<em>OR</em> 1.12 (95% <em>CI</em>, 1.02–1.23), <em>P</em> &lt; 0.05]. Kaplan-Meier analysis further showed that patients with lower TC/HDL-C ratios had significantly longer event-free survival over the 5-year follow-up (log-rank <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Elevated TC/HDL-C ratio is independently associated with an increased risk of stroke recurrence or death within 5 years in patients with first-ever IS. These findings support the utility of the TC/HDL-C ratio as a clinically relevant prognostic marker for long-term outcomes in IS patients.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 2","pages":"Pages 82-90"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147862802","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":"Sleep Disordered Breathing in Intracerebral Hemorrhage Survivors in Japan: a Meta-analysis and Systematic Review","authors":"Farhan Ishaq","doi":"10.1016/j.hest.2025.10.001","DOIUrl":"10.1016/j.hest.2025.10.001","url":null,"abstract":"<div><h3>Objective</h3><div>We evaluated the prevalence and correlates of sleep-disordered breathing (SDB) in intracerebral hemorrhage (ICH) survivors in Japan.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, Scopus, CINAHL, and <span><span>Clinicaltrials.gov</span><svg><path></path></svg></span> through April 1, 2020 identified studies reporting prevalence and severity of SDB in ICH survivors using American Academy of Sleep Medicine–approved devices. Apnea-hypopnea index (AHI) data were pooled using random-effects models. Subgroup analyses were performed by stroke phase, study design, and testing location.</div></div><div><h3>Results</h3><div>Two Japanese studies were included. The prevalence of SDB was high: AHI ≥ 5 in 91 % (95 % <em>CI</em>: 84–95), ≥15 in 56 % (39–72), and ≥ 30 in 22 % (11–39). Pooled mean AHI was 20.79 (14–27.55). Subgroup analysis showed significantly higher prevalence in prospective studies, inpatient units, and acute stroke compared with retrospective, rehabilitation, and subacute settings (all <em>P</em> &lt; 0.01). Severe SDB was more common in patients with dysarthria, dysphagia, higher BMI, and greater waist circumference; combined dysarthria and dysphagia independently predicted severe SDB (<em>OR</em> 3.4, 95 % <em>CI</em>: 1.25–9.25). Obstructive sleep apnea predominated over central sleep apnea (82.3 % <em>v.s.</em> 6.1 %, <em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>SDB is highly prevalent among Japanese ICH survivors, particularly in the acute inpatient setting. Oropharyngeal motor impairment may contribute to its development. Larger prospective studies are warranted.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 2","pages":"Pages 126-131"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147862806","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 blood lipid and triglyceride‑glucose index in intracranial aneurysms: A retrospective study","authors":"Xingwei Lei ,&nbsp;Yajun Zhu ,&nbsp;Liuyang Tang ,&nbsp;Daochen Wen ,&nbsp;Xiaoguo Li ,&nbsp;Zichao Huang ,&nbsp;Minghai Zhang ,&nbsp;Zongduo Guo ,&nbsp;Hai Su","doi":"10.1016/j.hest.2024.12.002","DOIUrl":"10.1016/j.hest.2024.12.002","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The association between blood lipids and aneurysmal subarachnoid hemorrhage (aSAH) remains uncertain, with current research yielding conflicting results. Limited studies have explored the link between the triglyceride-glucose (TyG) index and the prognosis of subarachnoid hemorrhage. In this retrospective study, we investigated the connection between blood lipids and aSAH, along with the correlation between the TyG index and the prognosis of aSAH.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;This study included 558 patients with IAs who were separated into two groups based on whether their aneurysms had ruptured or not. Moreover, according to the modified Rankin Scores (mRS), aSAH patients were categorized into the favorable prognosis group (mRS &lt; 3) and the poor prognosis group (mRS &gt; 3).The clinical data of gender, age, accompanied chronic diseases (hypertension, diabetes), cigarette history, alcohol history, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), blood glucose (BG), mRS of aSAH patients, and responsible aneurysm features were also recorded. The TyG index is calculated as ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. The &lt;em&gt;t&lt;/em&gt;-test, Mann-Whitney &lt;em&gt;U&lt;/em&gt; test, or one-way analysis of variance are used to compare differences in continuous variables, whilst the chi-square test or Fisher’s exact test is&lt;!--&gt; &lt;!--&gt;used to evaluate differences in categorical variables. Blood lipid levels were evaluated using multivariable logistic regression and receiver operating characteristic (ROC) analysis to examine their potential to predict IA rupture. Spearman correlation analysis was used to analyze the relationships between the TyG index and the mRS.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Result&lt;/h3&gt;&lt;div&gt;This study enrolled in 558 consecutive patients with 299 unruptured and 259 ruptured IAs patients. The results of the univariate analysis indicated that age, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) levels were higher in patients with ruptured IAs, while triglyceride (TG) levels were lower in ruptured group (&lt;em&gt;P&lt;/em&gt; &lt; 0.05). Female aSAH patients had higher levels of TC and LDL-C (&lt;em&gt;P&lt;/em&gt; &lt; 0.05). Different from female patients, the HDL-C levels in male ruptured patients was higher than unruptured (&lt;em&gt;P&lt;/em&gt; &lt; 0.05). Multivariate logistic regression model analysis showed that high levels of TC (&lt;em&gt;OR&lt;/em&gt; = 0.382, 95 %&lt;em&gt;Cl&lt;/em&gt;: 0.219 – 0.665) and LDL-C (&lt;em&gt;OR&lt;/em&gt; = 5.028, 95 %&lt;em&gt;Cl&lt;/em&gt;: 2.606 – 9.703) increased the risk of aSAH in female patients. High levels of HDL-C (&lt;em&gt;OR&lt;/em&gt; = 3.964, 95 %&lt;em&gt;Cl&lt;/em&gt;: 1.493– 10.525) increased the risk of aSAH in male patients. In aSAH patients, multivariable logistic regression showed that the TyG index was associated with the prognosis of aSAH. Correlation analysis showed that the TyG index was positively correlated with mRS (&lt;em&gt;rs&lt;/em&gt; = 0.","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 2","pages":"Pages 91-97"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147862801","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":"Inflammatory biomarkers in patients with intracranial aneurysms","authors":"Yu Xie ,&nbsp;Xuefei Li ,&nbsp;Zhiyuan Yu ,&nbsp;Qianqian Kong ,&nbsp;Xirui Zhou ,&nbsp;Yi Zhang ,&nbsp;Xubin Li ,&nbsp;Xiang Luo ,&nbsp;Dan He","doi":"10.1016/j.hest.2025.09.005","DOIUrl":"10.1016/j.hest.2025.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>Intracranial aneurysm (IA) is a serious cerebrovascular disease. This study aimed to investigate the clinical characteristics and plasma biomarkers associated with IA.</div></div><div><h3>Methods</h3><div>A total of 207 participants were enrolled: 45 with unruptured IA, 95 with ruptured IA, and 67 controls. Clinical characteristics, plasma biomarkers, peripheral blood macrophage subsets, and inflammatory cytokines in arterial wall tissue (from six ruptured IA patients and controls) were analyzed.</div></div><div><h3>Results</h3><div>Compared to controls, ruptured IA patients exhibited elevated D-dimer, high-sensitivity C-reactive protein and glucose, while unruptured IA patients showed increased platelet count and plateletcrit. Compared to unruptured cases, ruptured IA patients demonstrated higher glucose and D-dimer levels, but lower prothrombin activity and activated partial thromboplastin time. Logistic regression identified association between elevated epithelial neutrophil-activating peptide 78 (ENA78) and platelet with unruptured IA, whereas elevated glucose, D-dimer and matrix metalloproteinase-9 (MMP-9) were associated with ruptured IA. Arterial wall analysis showed upregulation of MMP-9, intercellular adhesion molecule-1, and ENA78 in IA patients. Ruptured IA patients exhibited an altered peripheral blood profile characterized by higher CD14⁻CD16⁺ cell proportion and decreased CD14⁺CD16⁻ cells compared to controls.</div></div><div><h3>Conclusion</h3><div>Both inflammatory cytokines and coagulation parameters are implicated in IA pathogenesis, suggesting their potential roles in the development and rupture of IA.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"7 2","pages":"Pages 75-81"},"PeriodicalIF":1.3,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147862803","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":"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}