Brain Hemorrhages最新文献

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Relationships between NT-pro-BNP and other serological indicators and the prognosis of spontaneous intracerebral hemorrhage NT-pro-BNP和其他血清学指标与自发性脑内出血预后的关系
IF 1.3
Brain Hemorrhages Pub Date : 2025-02-01 Epub Date: 2024-05-15 DOI: 10.1016/j.hest.2024.05.004
Jingxuan Wang , Danyang Chen , Yingxin Tang , Prativa Sherchan , Jiahui Wang , Ping Zhang , Zhouping Tang
{"title":"Relationships between NT-pro-BNP and other serological indicators and the prognosis of spontaneous intracerebral hemorrhage","authors":"Jingxuan Wang ,&nbsp;Danyang Chen ,&nbsp;Yingxin Tang ,&nbsp;Prativa Sherchan ,&nbsp;Jiahui Wang ,&nbsp;Ping Zhang ,&nbsp;Zhouping Tang","doi":"10.1016/j.hest.2024.05.004","DOIUrl":"10.1016/j.hest.2024.05.004","url":null,"abstract":"<div><h3>Objective</h3><div>Acute spontaneous intracerebral hemorrhage (ICH) is a life-threatening condition, and certain serological indicators may be associated with the prognosis after ICH. This study investigated the relationship between N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and other serological indicators with prognosis 90 days after the onset of acute ICH.</div></div><div><h3>Methods</h3><div>The general information, clinical, and follow-up data of patients with ICH who were admitted to the Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2019 to September 2022 were retrospectively collected. Based on the modified Rankin Scale (mRS) at 90 days of onset, the patients were divided into poor prognosis group (mRS &gt; 3) and good prognosis group (mRS ≤ 3), and the differences in various indicators between these two groups were compared. Serological indicators related to prognosis were determined by univariate and multivariate logistic regression analysis, and the predictive value was evaluated by receiver operating characteristic (ROC) analysis and decision curve analysis (DCA).</div></div><div><h3>Results</h3><div>A total of 121 patients with ICH were included in the study with 49 patients having a good prognosis and 72 patients having a poor prognosis. Multivariate logistic regression analysis showed that NT-pro-BNP at admission was associated with prognosis at 90 days after ICH onset (<em>P</em> &lt; 0.05). ROC and DCA analyses demonstrated that NT-pro-BNP had a certain predictive ability for ICH prognosis.</div></div><div><h3>Conclusions</h3><div>The level of NT-pro-BNP at admission may be an independent risk factor for predicting prognosis at 90 days after the onset of ICH. The higher the level, the worse the prognosis may be.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 1","pages":"Pages 14-18"},"PeriodicalIF":1.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141057569","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}
引用次数: 0
Cerebrovascular disorders in patients with malignant tumors 恶性肿瘤患者的脑血管疾病
IF 1.3
Brain Hemorrhages Pub Date : 2024-12-01 Epub Date: 2024-08-28 DOI: 10.1016/j.hest.2024.08.003
Ozal Beylerli , Rustam Talybov , Elmar Musaev , Tatyana Trofimova , Huaizhang Shi , Tatiana Ilyasova , Valentin Pavlov
{"title":"Cerebrovascular disorders in patients with malignant tumors","authors":"Ozal Beylerli ,&nbsp;Rustam Talybov ,&nbsp;Elmar Musaev ,&nbsp;Tatyana Trofimova ,&nbsp;Huaizhang Shi ,&nbsp;Tatiana Ilyasova ,&nbsp;Valentin Pavlov","doi":"10.1016/j.hest.2024.08.003","DOIUrl":"10.1016/j.hest.2024.08.003","url":null,"abstract":"<div><div>Patients with malignant tumors face an elevated risk of cerebrovascular complications, such as intratumoral hemorrhage, tumor invasion into arterial and venous sinuses, leptomeningeal infiltration, and tumor embolism. This review examines the significant role and implications of cisplatin and radiation therapy in the development of these cerebrovascular complications, which can occur at various stages: before, during, or long after the completion of cancer treatment. Detailed clinical case studies of CNS involvement during oncological therapy are presented to illustrate these complications. The mechanisms by which cisplatin and radiation therapy contribute to cerebrovascular disorders are multifaceted. Cisplatin, a widely used chemotherapeutic agent, is associated with endothelial damage and thromboembolic events, while radiation therapy can cause vascular injury, leading to long-term changes in cerebral vasculature. These treatments, though effective in managing malignancies, pose significant risks to cerebrovascular health. The review underscores the diverse types and mechanisms of stroke encountered in cancer patients, influenced by tumor stage and pathological characteristics. These include ischemic stroke, hemorrhagic stroke, and transient ischemic attacks, each requiring specific diagnostic and therapeutic strategies. The interaction between cancer pathology and cerebrovascular health necessitates a multidisciplinary approach, integrating oncology, neurology, radiology, and vascular surgery. Such an approach is crucial for effective management and prognosis evaluation in this patient population. Early recognition and intervention are paramount to mitigating risks and improving outcomes. By understanding these complex interactions, healthcare providers can better anticipate and manage cerebrovascular risks in patients undergoing cancer treatment. This comprehensive understanding helps in formulating personalized treatment plans, optimizing both oncological and neurological care, and ultimately enhancing patient quality of life and survival rates.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"5 6","pages":"Pages 284-292"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143168792","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}
引用次数: 0
Activation of PARP in secondary brain injury following intracerebral haemorrhage 脑出血后继发性脑损伤中PARP的激活
IF 1.3
Brain Hemorrhages Pub Date : 2024-12-01 Epub Date: 2024-08-28 DOI: 10.1016/j.hest.2024.08.004
Yan Zhang , Qiuyang Su , Guofeng Wu , Nathanael Matei , Shengling Zeng
{"title":"Activation of PARP in secondary brain injury following intracerebral haemorrhage","authors":"Yan Zhang ,&nbsp;Qiuyang Su ,&nbsp;Guofeng Wu ,&nbsp;Nathanael Matei ,&nbsp;Shengling Zeng","doi":"10.1016/j.hest.2024.08.004","DOIUrl":"10.1016/j.hest.2024.08.004","url":null,"abstract":"<div><div>Intracerebral hemorrhage (ICH) represents a significant health challenge due to its high mortality and severe outcomes. Poly (ADP-ribose) polymerase (PARP) is a chromatin-associated nuclear protease, which would be activated by ROS derived from hematoma metabolites after ICH, and lead to parthanatos, a form of caspase-independent programmed cell necrosis. Recent evidence indicates that PARP activation plays a pivotal role in various human diseases, particularly neurodegenerative disorders, cerebral ischemia–reperfusion injury, and hemorrhagic transformation. However, the link between PARP activation and secondary brain injury (SBI) following ICH remains underexplored. This review delves into the pathological mechanisms of PARP activation in cell injury, with a focus on parthanatos, mitochondrial dysfunction, neuroinflammation, and blood–brain barrier (BBB) disruption after ICH. Understanding these processes may offer new insights into the role of PARP activation in ICH and pave the way for developing more effective therapeutic strategies.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"5 6","pages":"Pages 293-298"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143168793","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}
引用次数: 0
Quadriparesis with bilateral anterior cerebral artery infarction following subarachnoid haemorrhage due to rupture of an anterior communicating artery aneurysm: A case report with literature review 前交通动脉瘤破裂导致蛛网膜下腔出血后双侧大脑前动脉梗死并发四肢瘫痪:病例报告及文献综述
IF 1.3
Brain Hemorrhages Pub Date : 2024-12-01 Epub Date: 2024-04-03 DOI: 10.1016/j.hest.2024.04.001
Zain Saleh, Farhat Abbas, Ahtesham Khizar, Bakht Nawaz
{"title":"Quadriparesis with bilateral anterior cerebral artery infarction following subarachnoid haemorrhage due to rupture of an anterior communicating artery aneurysm: A case report with literature review","authors":"Zain Saleh,&nbsp;Farhat Abbas,&nbsp;Ahtesham Khizar,&nbsp;Bakht Nawaz","doi":"10.1016/j.hest.2024.04.001","DOIUrl":"10.1016/j.hest.2024.04.001","url":null,"abstract":"<div><h3>Background</h3><div>Anterior cerebral artery (ACA) territory infarctions are relatively rare, accounting for 0.3 % to 4.4 % of stroke cases, with bilateral occurrences being even rarer. These infarctions can lead to quadriplegia/paresis. Bilateral ACA territory infarctions are possibly caused by vasospasm due to subarachnoid haemorrhage (SAH) from ruptured anterior communicating artery (ACoA) aneurysms or thrombosis in the presence of a rudimentary contralateral artery. ACoA aneurysm with quadriparesis is extremely unusual, with this being only the second recorded occurrence and the youngest reported. Overall, understanding the mechanisms and consequences of ACA territory infarctions, especially bilateral occurrences, remains crucial for effective diagnosis and management of such rare but serious neurological events.</div></div><div><h3>Case Presentation</h3><div>A 35-year-old male, previously healthy, presented with quadriparesis and an ACoA aneurysm. Initially experiencing a headache and brief loss of consciousness, he later developed right foot drop and progressive right-sided weakness, leading to altered consciousness. Subsequent imaging revealed SAH consistent with the aneurysm and also bilateral ACA territory infractions. Upon referral for further management, he presented with intact higher mental functions but motor deficits in the upper and lower limbs. Imaging and assessments confirmed the diagnosis, prompting a decision for craniotomy and clipping. Postoperatively, the patient showed improvement, with enhanced power in both upper limbs at one-month follow-up.</div></div><div><h3>Conclusion</h3><div>Bilateral ACA territory infarction is unusual, and the symptoms are not yet well understood. ACoA aneurysm with quadriparesis is extremely unusual. Understanding the mechanics and clinical consequences of bilateral ACA territory infarctions is critical for early detection and management.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"5 6","pages":"Pages 299-302"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140762048","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}
引用次数: 0
Brain Hemorrhages has specially appointed Professor Wang Yongjun from Beijing Tiantan Hospital as Honorary Editor-in-Chief Brian Hemorrhages》特聘北京天坛医院王勇军教授为名誉主编
IF 1.3
Brain Hemorrhages Pub Date : 2024-12-01 Epub Date: 2024-07-28 DOI: 10.1016/j.hest.2024.07.009
Yingxin Tang
{"title":"Brain Hemorrhages has specially appointed Professor Wang Yongjun from Beijing Tiantan Hospital as Honorary Editor-in-Chief","authors":"Yingxin Tang","doi":"10.1016/j.hest.2024.07.009","DOIUrl":"10.1016/j.hest.2024.07.009","url":null,"abstract":"","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"5 6","pages":"Pages 303-304"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846609","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}
引用次数: 0
Mid-term outcomes in stent-assisted coil embolization for ruptured cerebral aneurysms in the acute period: A single institution retrospective review 支架辅助线圈栓塞治疗急性期破裂脑动脉瘤的中期疗效:单机构回顾性研究
IF 1.3
Brain Hemorrhages Pub Date : 2024-12-01 Epub Date: 2024-06-13 DOI: 10.1016/j.hest.2024.06.002
Hannaly Cheuk Hang Lui , Yuen Ting Ng , Simon Chun Ho Yu , James Tin Fong Zhuang , George Kwok Chu Wong
{"title":"Mid-term outcomes in stent-assisted coil embolization for ruptured cerebral aneurysms in the acute period: A single institution retrospective review","authors":"Hannaly Cheuk Hang Lui ,&nbsp;Yuen Ting Ng ,&nbsp;Simon Chun Ho Yu ,&nbsp;James Tin Fong Zhuang ,&nbsp;George Kwok Chu Wong","doi":"10.1016/j.hest.2024.06.002","DOIUrl":"10.1016/j.hest.2024.06.002","url":null,"abstract":"<div><h3>Objective</h3><div>The purposes of this study were to retrospectively review mid-term outcomes of stent-assisted coil embolization for acutely ruptured cerebral aneurysms, and to identify risk factors.</div></div><div><h3>Methods</h3><div>Between April 2013 and October 2018, thirty-four consecutive patients had stent-assisted coil embolization for treatment of acutely ruptured cerebral aneurysms that were not amendable by simple coiling. Hospital subarachnoid hemorrhage registry and notes on hospital electronic medical systems were retrospectively reviewed. All patients had a dose of intravenous abciximab 10 mg and heparin 2000 units before stenting and started dual antiplatelet therapy after procedure.</div></div><div><h3>Results</h3><div>Of the thirty-four consecutive patients, twenty-six (76 %) were treated with braided stents and eight (24 %) were treated with laser-cut stents. There was no rebleeding in thirty-two patients who achieved total aneurysmal occlusion or residual neck only. Rebleeding occurred in two patients who only achieved partial embolization, resulting in mortality. There were three (9 %) thromboembolic complications, in which two were ADL-independent upon hospital discharge and the one with WFNS Grade V succumbed. Twenty (59 %) patients achieved clinical favorable outcomes (mRS 0–2) at follow-up (mean+/-SD: 17+/-15 months). The need of EVD insertion was a statistically significant risk factor for procedure-related cerebral infarction, intracerebral hemorrhage and 30-day mortality. The GOS and mRS were closely related to the need of EVD insertion and sidewall location of aneurysm.</div></div><div><h3>Conclusions</h3><div>The study established the efficacy and safety profile of stent-assisted embolization for treatment acutely ruptured cerebral aneurysms. The embolization goal should be total aneurysmal occlusion or with minimal residual neck to prevent rebleeding and reduce mortality. The use of such technique should be considered when simple coiling or microsurgical clipping is not feasible or suitable. The need of EVD insertion is an independent risk factor for intracerebral hematoma and 30-day mortality. When needed, EVD insertion shall be considered before antiplatelet agents, and require exceptionally meticulous hemostasis intraoperatively.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"5 6","pages":"Pages 267-273"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141402885","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}
引用次数: 0
Effects of glibenclamide/glyburide on stroke: Systematic review 格列本脲/格列本脲对中风的影响:系统回顾
IF 1.3
Brain Hemorrhages Pub Date : 2024-12-01 Epub Date: 2024-07-26 DOI: 10.1016/j.hest.2024.07.006
Natasha Cordeiro dos Santos, Nathan Nascimento Loureiro, Larissa Santana Correia, Roque Aras Junior
{"title":"Effects of glibenclamide/glyburide on stroke: Systematic review","authors":"Natasha Cordeiro dos Santos,&nbsp;Nathan Nascimento Loureiro,&nbsp;Larissa Santana Correia,&nbsp;Roque Aras Junior","doi":"10.1016/j.hest.2024.07.006","DOIUrl":"10.1016/j.hest.2024.07.006","url":null,"abstract":"<div><h3>Introduction</h3><div>Glibenclamide (GBC), although traditionally used to treat type 2 diabetes mellitus, has demonstrated efficacy in preventing cerebral edema in the setting of stroke, including preserving the integrity of the vascular endothelium, reducing edema and inhibiting brain death. The objective is to investigate the effects of glibenclamide in individuals who have suffered a stroke.</div></div><div><h3>Methods</h3><div>This is a systematic review. The following databases were used: EMBASE, MEDLINE, Lilacs, Scielo, Cochrane Library and Science Direct. Data collection was carried out from June to November 2023. Studies were included in which the effects of glibenclamide were evaluated in individuals (of both sexes and without age restrictions) diagnosed with stroke. The studies should have been published in the last 10 years; there was no restriction on the language of publication. Review studies and studies that included other pathologies in the same group were excluded.</div></div><div><h3>Results</h3><div>10 articles were included. The total number of participants was 853 individuals. The results of the studies demonstrated, in general, lower mortality, reduction in midline displacement and cerebral edema in the groups that used glibencamide. There were no hemorrhagic events or hypoglycemia.</div></div><div><h3>Conclusions</h3><div>The use of glibenclamide had a favorable effect on individuals who had suffered a stroke. However, new studies with a larger sample size and involving other databases are needed so that these results can be generalized and the use of GBC in stroke can be validated.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"5 6","pages":"Pages 274-283"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845535","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}
引用次数: 0
Assessment of causal relationships between white matter brain imaging-derived phenotypes and CSVD-mediated Stroke: Genetic correlation and Mendelian randomization 评估白质脑成像衍生表型与csvd介导的卒中之间的因果关系:遗传相关性和孟德尔随机化
IF 1.3
Brain Hemorrhages Pub Date : 2024-12-01 Epub Date: 2024-08-28 DOI: 10.1016/j.hest.2024.08.005
Haomiao Wang , Shitao Fan , Jinxin Lin , Xuyang Zhang , Tengyuan Zhou , Ran Luo , Chao Zhang , Shuixian Zhang , Qingwu Yang , Rong Hu
{"title":"Assessment of causal relationships between white matter brain imaging-derived phenotypes and CSVD-mediated Stroke: Genetic correlation and Mendelian randomization","authors":"Haomiao Wang ,&nbsp;Shitao Fan ,&nbsp;Jinxin Lin ,&nbsp;Xuyang Zhang ,&nbsp;Tengyuan Zhou ,&nbsp;Ran Luo ,&nbsp;Chao Zhang ,&nbsp;Shuixian Zhang ,&nbsp;Qingwu Yang ,&nbsp;Rong Hu","doi":"10.1016/j.hest.2024.08.005","DOIUrl":"10.1016/j.hest.2024.08.005","url":null,"abstract":"<div><h3>Objective</h3><div>Cerebral small vessel disease (CSVD) and its associated stroke are significant contributors to mortality and long-term disability globally. Despite this, there remains a lack of established predictors or preventive strategies for stroke mediated by CSVD, beyond the management of hypertension. In this study, we explored the potential utility of imaging-derived phenotypes (IDPs) of white matter (WM) as risk predictors for CSVD-mediated stroke and clarify the underlying causal relationships.</div></div><div><h3>Methods</h3><div>We performed a genetic correlation analysis to assess the relationship between WM IDPs and CSVD-mediated stroke, identifying genetically correlated pairs for follow-up Mendelian randomization (MR) studies. Subsequently, we examined the mediating role of WM IDPs in the correlation between blood pressure (BP) traits and CSVD-mediated stroke.</div></div><div><h3>Results</h3><div>Our findings demonstrate a significant causal relationship between genetic predisposition to increased isotropic or free water volume fraction (ISOVF) in the anterior limb of the left internal capsule (ALLIC) and CSVD-mediated stroke (IVW: odds ratio [OR] = 1.57; 95 % CI: 1.25 to 1.96, p = 8.27 × 10<sup>–5</sup>).</div></div><div><h3>Conclusions</h3><div>This study provides evidence for a potential causal link between WM IDPs and CSVD-mediated stroke, which may enhance the predictive capacity for CSVD-mediated stroke.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"5 6","pages":"Pages 261-266"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143168791","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}
引用次数: 0
Recent trends of treatment strategies and outcomes of basal ganglia hemorrhages at a single institution 一家医疗机构基底节出血治疗策略和疗效的最新趋势
IF 1.3
Brain Hemorrhages Pub Date : 2024-10-01 Epub Date: 2024-03-21 DOI: 10.1016/j.hest.2024.03.001
{"title":"Recent trends of treatment strategies and outcomes of basal ganglia hemorrhages at a single institution","authors":"","doi":"10.1016/j.hest.2024.03.001","DOIUrl":"10.1016/j.hest.2024.03.001","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;The Early Minimally Invasive Removal of Intracerebral Hemorrhage (ENRICH) Trial was designed to evaluate the minimally invasive &lt;em&gt;trans&lt;/em&gt;-sulcal parafascicular surgery (MIPS) approach, a technique advertised for safe access to deep brain structures and ICH removal using the BrainPath® and Myriad® devices (NICO Corporation, Indianapolis, IN). However, basal ganglia hemorrhages (BGHs) were determined to meet the a priori futility rule, resulting in exclusion from further trial enrollment consideration. Since screening for ICH is initiated immediately upon presentation of symptom bearing patients, treatment is curtailed to best preserve remaining neurological function. We sought to determine whether immediate exclusion from consideration of trial enrollment resulted in poorer patient outcomes despite best medical or surgical management.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A retrospective, observational, cohort analysis was performed on data extrapolated from our institution’s intracranial hemorrhage (ICH) screening log. All patients included in this study either (1) were excluded from the ENRICH trial for not meeting trial inclusion criteria or (2) presented on and after February 27&lt;sup&gt;th&lt;/sup&gt;, 2019 when BGHs. This inflection point in time was chosen based on the ENRICH trial’s decision to enact an a priori futility rule. Demographical, medical comorbities, presenting features, treatment characteristics, and outcomes were collected by chart review on all patients. These dichotimized groups were compared by univariate and multivariate statistical approaches. The main outcome of interest was functional status at 90 days as measured by the modified Rankin Scale.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;There were 52 patients with BGHs who presented before the interim exclusion decision, and 67 patients who presented after. The proportion of patients with intraventricular hemorrhage (IVH) occupying &gt; 50 % of either lateral ventricle was higher in the “before” group (40.4 % vs 20.9 %, p = 0.026). There was a significant difference in the evacuation method used, with more patients in the “after” group undergoing craniotomy (10.5 % vs 0 %, p = 0.018). The 90-day mRS scores of 0–2 were significantly lower for patients who presented after the interim exclusion (16.4 % vs 36.5 %, p = 0.019). The 180-day mortality was not significantly different between the two groups (p = 0.56). In multivariate logistical regression, diabetes mellitus, hematoma volume at presentation, and presentation date were significant predictors of a “good” neurological outcome (90-day mRS score of 0–2). A 1 mL increase in hematoma volume at presentation was associated with a 4 % decrease in the likelihood of a good outcome (OR = 0.960, 95 % CI = 0.924–0.997, p = 0.033). Patients who presented after the interim exclusion had a 79.5 % lower likelihood of a “good” neurological outcome compared to those who presented before the interim exclusion (OR = 0.20","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"5 5","pages":"Pages 205-212"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140276018","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}
引用次数: 0
Effect of mesenchymal stem cell-derived exosomes on the inflammatory response after stroke 间充质干细胞衍生的外泌体对中风后炎症反应的影响
IF 1.3
Brain Hemorrhages Pub Date : 2024-10-01 Epub Date: 2024-04-20 DOI: 10.1016/j.hest.2024.04.003
{"title":"Effect of mesenchymal stem cell-derived exosomes on the inflammatory response after stroke","authors":"","doi":"10.1016/j.hest.2024.04.003","DOIUrl":"10.1016/j.hest.2024.04.003","url":null,"abstract":"<div><div>Stroke, characterized by sudden onset and significant mortality rates, represents a critical challenge in effectively treating neuroinflammation to improve treatment efficacy. In this context, mesenchymal stem cell (MSC)-derived exosomes have attracted significant attention in scientific research due to their diverse cellular origin, tiny size, and huge number of bioactive molecules. Recent studies have shed light on the remarkable potential of MSC-derived exosomes to not only suppress the inflammatory responses of microglia and astrocytes, but also enhance their neuroprotective functions. Moreover, these exosomes have demonstrated a remarkable ability to modulate various immune cells and inflammatory mediators, thereby exerting profound mitigating effects on neuroinflammation. Through a thorough examination of the role and underlying mechanisms of MSC-derived exosomes in mitigating neuroinflammation after stroke, this review aims to provide comprehensive information and recommendations for the development of innovative therapeutic strategies aimed at significantly improving the treatment of stroke.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"5 5","pages":"Pages 248-256"},"PeriodicalIF":1.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140774396","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}
引用次数: 0
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