Intracerebral hemorrhage stroke

Brooks RA, Di Chiro G, Patronas N et al (1989) MR imaging of cerebral hematomas at different field strengths theory and applications. Comput Assist Tomogr 13 194-206 Brott T, Broderick JP, Kothari R et al (1997) Early hemorrhage growth in patients with intracerebral hemorrhage. Stroke 28 1-5... 

Schellinger PD, Jansen O, Fiebach JB et al (1999). A standardized MRI stroke protocol comparison with CT in hyperacute intracerebral hemorrhage. Stroke 30 765-768 Schellinger PD, Thomalla G, Fiehler J et al (2007). MRI-based and CT-based thrombolytic therapy in acute stroke within and beyond established time windows an analysis of 1210 patients. 

Nakamura T, Kuroda Y, Yamashita S, Zhang X, Miyamoto O, Tamiya T, Nagao S, Xi G, Keep RF, Itano T (2008) Edaravone attenuates bndn edema and neurologic deficits in a rat model of acute intracerebral hemorrhage. Stroke 39 463 69... 

Jung KH, Chu K, Jeong SW, Han S Y, Lee ST, Kim JY, Kim M, Roh JK (2004) HMG-CoA reductase inhibitor, atorvastatin, promotes sensorimotor recovery, suppressing acute inflammatory reaction after experimental intracerebral hemorrhage. Stroke 35 1744—1749. 

Lopez-Yunez, A.M., et al., Protocol violations in community-based rTPA stroke treatment are associated with symptomatic intracerebral hemorrhage. Stroke, 2001. 32(1) p. 12-6. 

The modern period in the history of stroke began in the 1960s when C. Miller Fisher described detailed clinical and pathological observations on the features of lacunar strokes, carotid artery disease, transient ischemic attacks, and intracerebral hemorrhage. His student Louis Caplan established one of the first stroke registry... 

Anonymous. Intracerebral hemorrhage after intravenous t-PA therapy for ischemic stroke. The NBSfDS t-PA Stroke Study Group. Stroke 1997 28 2109-2118. 

Tanne D, Kasner SE, Demchuk AM, Koren-Morag N, Hanson S, Grond M, Levine SR. Markers of increased risk of intracerebral hemorrhage after intravenous recombinant tissue plasminogen activator therapy for acute ischemic stroke in clinical practice The Multicenter rt-PA Stroke Survey. Circulation. 2002 105 1679-1685. 

The efficacy of IV thrombolysis in patients with moderate-to-severe strokes due to proximal arterial occlusions is restricted by several factors, including the relatively short therapeutic window, poor recanalization rates as the clot burden increases, restrictive eligibility criteria, and the risk of intracerebral hemorrhage. Endovascular techniques improve the rates of recanalization in this patient population, and appear to increase the likelihood of a good functional outcome. Intravenous thrombolysis... 

Greer DM, Koroshetz WJ, Cullen S, Gonzalez RG, Lev MH. Magnetic resonance imaging improves detection of intracerebral hemorrhage over computed tomography after intra-arterial thrombolysis. Stroke 2004 35 491 95. 

The timing of CEA after ischemic stroke has been a controversial issue. In 1969, the Joint Study of Extracranial Arterial Occlusion reported 42% mortality after CEA in patients with neurological deficits of less than 2 weeks duration, compared with 5% mortality in patients with more than 2 weeks of symptoms. Early evidence also demonstrated an increased risk of intracerebral hemorrhage after early CEA in patients with acute stroke. This led to the conclusion that most complications occurred with early surgical intervention, and resulted in a traditional 4-6 week delay for CEA after an acute stroke. In retrospect, however, there were major problems with patient selection in these earlier reports. Many of the patients... 

Caplan LR, Skilhnan J, Ojemann R, Eields WS. Intracerebral hemorrhage following carotid endarterectomy a h3fpertensive complication Stroke 1978 9 457-460. 

Placebo-Controlled Trials ofUFH, LMWH, and Heparinoids The International Stroke Trial (1ST) was a randomized, placebo-controlled trial of UFH (5000 or 12,500 lU twice daily) and aspirin (300 mg) in 19,435 unselected patients with acute stroke within 48 hours of symptom onset. Because of limited availability of neuroimaging, 33% of participants were enrolled with suspected but not proven ischemic stroke, some of whom may have suffered primary intracerebral hemorrhage (ICH). 

Corticosteroids have been evaluated in several types of cerebral injury, including cerebral infarction. Corticosteroids reduce vasogenic edema, such as that associated with neoplasms, but not cytotoxic edema, the type associated with ischemic stroke. A large meta-analysis found no benefit to the use of corticosteroids in ischemic stroke (or intracerebral hemorrhage), and their use is not recommended, except to treat concomitant conditions that mandate it (e.g., COPD flare). 

Demchuk AM, Morgenstem LB, Krieger DW, Linda Chi T, Hu W, Wein TH, Hardy RJ, Grotta JC, Buchan AM. Serum glucose level and diabetes predict tissue plasminogen activator-related intracerebral hemorrhage in acute ischemic stroke. Stroke 1999 30(l) 34-39. 

Leira R, Davalos A, Silva Y, Gil-Peralta A, Tejada J, GarciaM, Castillo J Stroke Project, Cerebrovascular Diseases Group of the Spanish Neurological Society. Early neurological deterioration in intracerebral hemorrhage Predictors and associated factors. Neurology 2004 63(3) 461 67. 

Five randomized primary and secondary prevention trials " have demonstrated the efficacy and safety of warfarin in preventing AF-related stroke. Pooled data from these trials demonstrated a 68% reduction in ischemic stroke (95% Cl 50-79) and an intracerebral hemorrhage rate of <1% per year. The data for aspirin suggested that it had a lesser effect, with a 36% risk reduction (95% Cl 4—57). 

The REACH system in southern Georgia (United States) and the TEMPiS system in Germany reported decreased latency to rt-PA delivery on a larger scale. REACH system investigators reported 194 acute stroke consultations dehvered via telemedicine. The time from symptom onset to rt-PA delivery decreased from 143 minutes in the first 10 patients treated to 111 minutes in last 20 patients of 30 patients treated with rt-PA, 23% were treated in 90 minutes or less and 60% were treated within 2 hours without any incidence of post-treatment symptomatic intracerebral hemorrhage. In 2004, the second year of the TEMPiS system, 115 patients in telemedicine-networked community hospitals and 110 patients in stroke centers received rt-PA for acute ischemic stroke or TIA. Patients treated at networked community... 

Hemorrhagic stroke is a result of bleeding into the brain and other spaces within the central nervous system and includes subarachnoid hemorrhage, intracerebral hemorrhage, and subdural hematomas. 

Hemorrhagic strokes account for 12% of strokes and include subarachnoid hemorrhage, intracerebral hemorrhage, and subdural hematomas. Subarachnoid hemorrhage may result from trauma or rupture of an intracranial aneurysm or arteriovenous malformation. Intracerebral hemorrhage occurs when a ruptured blood vessel within the brain parenchyma causes formation of a hematoma. Subdural hematomas are most often caused by trauma. 

The use of full-dose unff actionated heparin in the acute stroke period has not been proven to positively affect stroke outcome, and it significantly increases the risk of intracerebral hemorrhage. Trials of low-molecular-weight heparins and heparinoids have been largely negative and do not support their routine use in stroke patients. 

Nimodipine, a member of the dihydropyridine group of calcium channel blockers, has a high affinity for cerebral blood vessels and appears to reduce morbidity after a subarachnoid hemorrhage. Nimodipine was approved for use in patients who have had a hemorrhagic stroke, but it has recently been withdrawn. Nicardipine has similar effects and is used by intravenous and intracerebral arterial infusion to prevent cerebral vasospasm associated with stroke. Verapamil as well, despite its lack of vasoselectivity, is used by the intra-arterial route in stroke. Some evidence suggests that calcium channel blockers may also reduce cerebral damage after thromboembolic stroke. 

Linfante I, Llinas RH, Caplan LR, Warach S (1999) MRI features of intracerebral hemorrhage within 2 hours from symptom onset. Stroke 30 2263-2267... 

Many individuals with LA also harbor lacunar and/or cortical infarcts. Presence of LA serves as an intermediate surrogate both for ischemic stroke and intracerebral hemorrhage as they all share similar risk factors and similar pathophysiological mechanisms (Inzitari 2003). LA is widely found in dementing illnesses, such as Alzheimer s disease, vascular dementia, and cerebral autosomal dominant arteri-opathy with subcortical infarcts and leukoencepha-lopathy (CADASIL). Failure of blood supply in the... 

Broderick JP, Adams HP Jr, Barsan W et al (1999) Guidelines for the management of spontaneous intracerebral hemorrhage a statement for healthcare professionals from a special writing group of The Stroke Council, American Heart Association. Stroke 30 905-915... 

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