Rapid resolution of signs of primary intracerebral haemorrhage in computed tomograms of the brain.

Intracerebral haemorrhage (ICH) is a devastating condition with limited treatment options, and current understanding of pathophysiology is incomplete. Spontaneous cerebral bleeding is a characteristic of the human condition that has proven difficult to recapitulate in existing pre-clinical rodent models. Zebrafish larvae are frequently used as vertebrate disease models and are associated with several advantages, including high fecundity, optical translucency and non-protected status prior to 5 days post-fertilisation. Furthermore, other groups have shown that zebrafish larvae can exhibit spontaneous ICH. The aim of this study was to investigate whether such models can be utilised to study the pathological consequences of bleeding in the brain, in the context of pre-clinical ICH research. Here, we compared existing genetic (bubblehead) and chemically inducible (atorvastatin) zebrafish larval models of spontaneous ICH and studied the subsequent disease processes. Through live, non-invasive imaging of transgenic fluorescent reporter lines and behavioural assessment we quantified brain injury, locomotor function and neuroinflammation following ICH. We show that ICH in both zebrafish larval models is comparable in timing, frequency and location. ICH results in increased brain cell death and a persistent locomotor deficit. Additionally, in haemorrhaged larvae we observed a significant increase in macrophage recruitment to the site of injury. Live in vivo imaging allowed us to track active macrophage-based phagocytosis of dying brain cells 24 hours after haemorrhage. Morphological analyses and quantification indicated that an increase in overall macrophage activation occurs in the haemorrhaged brain. Our study shows that in zebrafish larvae, bleeding in the brain induces quantifiable phenotypic outcomes that mimic key features of human ICH. We hope that this methodology will enable the pre-clinical ICH community to adopt the zebrafish larval model as an alternative to rodents, supporting future high throughput drug screening and as a complementary approach to elucidating crucial mechanisms associated with ICH pathophysiology.

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Penanganan Pasien Perdarahan Intraserebral di Ruang Rawat Intensif

e-CliniC ◽

10.35790/ecl.v9i1.31705 ◽

2021 ◽

Vol 9 (1) ◽

Author(s):

Rian Ibrahim ◽

Diana Ch. Lalenoh ◽

Mordekhai L. Laihad

Keyword(s):

Blood Pressure ◽

Intensive Care Unit ◽

Intensive Care ◽

Intracerebral Haemorrhage ◽

Intracranial Haemorrhage ◽

Radiological Evaluation ◽

Systemic Complications ◽

General Management ◽

Life Threatening ◽

The Brain

Abstract: Intracerebral haemorrhage is a type of intracranial haemorrhage that occurs due to rupture of blood vessels in the brain tissue which is caused by trauma, hypertension, and nonhypertension. The intensive care unit is a separate section within the hospital that treats patients with life-threatening conditions, undergoing resuscitation, requiring intensive care and monitoring, and containing equipment and medicines to maintain normal body functions. All patients who are treated with intracerebral haemorrhage in intensive care unit should receive attention in terms of radiological evaluation, maintaining adequate respiration and circulation, controlling intracranial pressure, controlling blood pressure, preventing hyperglycemia, hypotension, and fever, controlling neurosurgical surgeries as well as preventing seizures. Surgery is performed to evacuate the accessible hematoma, depending on the location of the hematoma in intracerebral. In general, management of the patients aims to minimize nerve damage, prevent and treat systemic complications, speed recovery, and prevent or slow down recurrences and complications. Outcome of patient with intracerebral haemorrhage will be better if the patient is treated specifically in the intensive care unit.Keywords: management, intracerebral haemorrhage, intensive care unit Abstrak: Perdarahan intraserebral terjadi akibat robeknya pembuluh darah dalam jaringan otak yang dapat disebabkan oleh trauma, hipertensi, dan non hipertensi. Ruang rawat intensif merupakan bagian tersendiri di dalam rumah sakit yang merawat pasien dengan kondisi mengancam jiwa, yang sedang menjalani resusitasi, membutuhkan perawatan dan pemantauan secara intensif, serta yang didalamnya terdapat peralatan maupun obat-obatan yang berguna untuk menjaga fungsi tubuh seperti normal. Semua penderita yang dirawat dengan perdarahan intraserebral di ruang rawat intensif harus mendapat perhatian dalam hal evaluasi radiologik, menjaga adekuatnya respirasi dan sirkulasi, pengendalian tekanan intrakranial, pengendalian tekanan darah, pencegahan hiperglikemi, hipotensi dan demam, pengontrolan terhadap operasi pembedahan saraf dan pencegahan kejang. Pembedahan dilakukan untuk evakuasi hematom yang dapat dijangkau, tergantung lokasi hematoma di intraserebral. Penanganan yang dilakukan bertujuan untuk meminimalkan kerusakan saraf, mencegah dan mengobati komplikasi sistemik yang terjadi, mempercepat pemulihan dan mencegah atau memperlambat kekambuhan dan komplikasi. Outcome pasien perdarahan intraserebral akan lebih baik, jika pasien dirawat khusus di ruang rawat intensif.Kata kunci: penanganan, perdarahan intrasereberal, ruang rawat intensif

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Antiplatelets after intracerebral haemorrhage: treat the patient, not the brain imaging

The Lancet Neurology ◽

10.1016/s1474-4422(19)30189-9 ◽

2019 ◽

Vol 18 (7) ◽

pp. 617-619

Author(s):

Hanne Christensen

Keyword(s):

Brain Imaging ◽

Intracerebral Haemorrhage ◽

The Brain

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Preliminary Report on Transorbital Leucotomy

Journal of Mental Science ◽

10.1192/bjp.96.405.935 ◽

1950 ◽

Vol 96 (405) ◽

pp. 935-950 ◽

Cited By ~ 3

Author(s):

Alan M. Edwards

Keyword(s):

Intracerebral Haemorrhage ◽

Preliminary Report ◽

Operative Death ◽

Caudate Nuclei ◽

Bony Landmarks ◽

Frontal Sinuses ◽

The Brain

One's approach to transorbital leucotomy must be critical for many reasons, chiefly that it is another blind operation with all the deficiencies this signifies. Meyer and McLardy have demonstrated the variety of anatomical sites in which lesions may be found following prefrontal leucotomy, and have stressed the variability in the position of the underlying cortex in its relations to the bony landmarks of the skull. Once more, sweeps are to be made with a blunt instrument, and the differing consistency of the brain, and perhaps its movement, will make it impossible to be certain whether the lesion produced is the size intended and in the position calculated. The dangers of intracerebral haemorrhage exist as before, and, in addition, because of the site of entry, there are chances of introducing infection, of cerebral rhinorrhea resulting from damage to the frontal sinuses, and of raising bone spicules from the orbital plate. More recently McLardy has said that with the addition of the deep frontal cut, were the caudate nuclei to be damaged bilaterally, restlessness, persisting incontinence and “delayed operative death” might occur, as may follow posterior cuts in prefrontal leucotomy.

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