Abstract WP308: Global Cerebral Edema Among Good Grade Patients with Intracerebral Hemorrhage. Results from the Antihypertensive Treatment of Acute Cerebral Hemorrhage (ATACH) Study

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Shahram Majidi ◽  
Waqas I Gilani ◽  
Nauman Tariq ◽  
Haitham M Hussein ◽  
Yuko Y Palesch ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Ct Scan ◽  
Brain Edema ◽  
Cerebral Edema ◽  
Brain Volume ◽  
Prognostic Significance ◽  
Ct Scans ◽  
Total Brain Volume ◽  
Total Brain ◽  
Global Brain

INTRODUCTION: There is some evidence that injury and blood brain barrier disruption can be seen in regions distant from the hematoma in patients with intracerebral hemorrhage (ICH). Objective: To ascertain the occurrence of global brain edema in patients with ICH and to explore the relationship between patient characteristics and three month outcomes. Design: A post-hoc analysis of a traditional Phase I dose escalation multicenter prospective study recruited patients with ICH, elevated SBP≥170 mmHg, and Glasgow Coma Scale score ≥8, who presented within 6 hours of symptom onset. Computed tomographic (CT) scans at baseline, 24 hours, and any performed at later intervals were submitted to a core image laboratory. We were able to ascertain the presence and magnitude of global brain edema in 41 of 60 subjects with adequate CT scan resolution. Settings: Emergency departments and intensive care units. Primary Outcomes: We determined the total brain, hematoma, and perihematoma edema volumes from baseline, 24 hour, and 48 hour (if available) CT scans using image analysis software. The global brain edema volume was determined by subtracting the hematoma and perihematomal edema volumes from the total brain volume. Results: A total of 18 (44%) of 41 patients had global cerebral edema that developed between initial CT scan and 24 hour CT scan. The median increase in brain volume among the 18 subjects was 35 cc ranging from 0.12 cc to 296 cc. The baseline GCS score (median 15 versus 15) and hematoma volume (mean±SD; 11.5±10.3 versus 13.9±17) were similar between subjects who experienced global cerebral edema and those who did not. The initial serum glucose was higher among subjects with global cerebral edema (150.5±74.3 mg/dl verus 119.7±34.6 mg/dl). Of the 18 patients who underwent a CT scan at 48 hours, 5 had either new or worsening global cerebral edema. Three of the 18 patients with global cerebral edema underwent neurological deterioration and 1 patient died during hospitalization. Conclusions: Global cerebral edema can occur even in subjects with mild ICH. The pathophysiological basis and prognostic significance needs to be studied in future trials.

scholarly journals ABC/XYZ Estimates Intracerebral Hemorrhage Volume as a Percent of Total Brain Volume in Children

Stroke ◽  
2010 ◽  
Vol 41 (4) ◽  
pp. 691-694 ◽  
Author(s):  
Lauren A. Beslow ◽  
Rebecca N. Ichord ◽  
Scott E. Kasner ◽  
Michael T. Mullen ◽  
Daniel J. Licht ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Brain Volume ◽  
Total Brain Volume ◽  
Total Brain ◽  
Hemorrhage Volume

Abstract TP398: Cognitive Performance Over Time in Children With Intracerebral Hemorrhage

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Lexa K Murphy ◽  
Bruce E Compas ◽  
Melissa C Gindville ◽  
Kristen L Reeslund ◽  
Lori C Jordan
Keyword(s):  
Intracerebral Hemorrhage ◽  
Cognitive Performance ◽  
Brain Volume ◽  
Cognitive Outcomes ◽  
Cognitive Testing ◽  
Total Brain Volume ◽  
Cognitive Difficulties ◽  
Total Brain ◽  
Low Performance ◽  
Over Time

Introduction: Spontaneous intracerebral hemorrhage (ICH) accounts for 40% of stroke in children. Few studies report cognitive outcomes and none have conducted serial testing over time. We hypothesized that children with ICH would continue to make cognitive improvements over a two-year period. Methods: Children with spontaneous ICH, including those with primary intraparenchymal hemorrhage (IPH) and/or intraventricular hemorrhage (IVH), were prospectively enrolled from 2011-2015 at a single institution. Two raters measured total brain volume, IPH, and IVH volumes. Outcome was assessed with the Pediatric Stroke Outcome Measure and a cognitive testing battery (Wechsler IQ) at 3 (T1), 12 (T2) and 24 months (T3) after ICH. Results: Sample included 7 children, 6-16 years (median=12.9); 2 had pure ICH, 1 had pure IVH, and 4 had both. Brain AVM was the cause of ICH in 6 of 7; 1 was idiopathic. Initial Glasgow coma scale ranged from 3-14 (median=9). Median hemorrhage volume as a percentage of brain volume was 1.96, interquartile range (IQR) 1.17-3.74. Total PSOMs improved over time from median of 3 (IQR=1.5-4.5) at T1 to 2 (IQR =0.5-3.0) at T3. PSOM worsened in 2 children, 1 with recurrent ICH (pt #2) and 1 with worsening expressive language and increased depression despite full surgical resection of AVM (pt #3). However, serial cognitive testing indicated greater heterogeneity over time, including general improvements in Verbal IQ and sustained low performance in working memory and processing speed in a subgroup (Figure). Conclusion: Children with spontaneous ICH may continue to improve cognitively over two years. However, cognitive performance is heterogeneous across participants and across domains of cognitive functioning with some worsening as cognitive demands increase developmentally with age. Clinical implications include the need for early and serial cognitive testing to assess for cognitive difficulties as children age.

scholarly journals Pyruvate to Lactate Metabolic Changes during Neurodevelopment Measured Dynamically Using Hyperpolarized 13C Imaging in Juvenile Murine Brain

2015 ◽  
Vol 38 (1) ◽  
pp. 34-40 ◽  
Author(s):  
Yiran Chen ◽  
Hosung Kim ◽  
Robert Bok ◽  
Subramaniam Sukumar ◽  
Xin Mu ◽  
...  
Keyword(s):  
Body Weight ◽  
Magnetic Resonance ◽  
Mouse Brain ◽  
Brain Volume ◽  
Metabolic Changes ◽  
Brain Maturation ◽  
Multiple Time ◽  
Total Brain Volume ◽  
Hyperpolarized 13C ◽  
Total Brain

Hyperpolarized 13C magnetic resonance imaging has recently been used to dynamically image metabolism in vivo. This technique provides the capability to investigate metabolic changes in mouse brain development over multiple time points. In this study, we used 13C magnetic resonance spectroscopic imaging and hyperpolarized 13C-1-labeled pyruvate to analyze its conversion into lactate. We also applied T2-weighted anatomical imaging to examine brain volume changes starting from postnatal day 18 (P18). We combined these results with body weight measurements for a comprehensive interpretation of mouse brain maturation. Both the produced lactate level and pyruvate to lactate conversion rate decreased with increasing age in a linear manner. Total brain volume remained the same after P18, even though body weight continued to grow exponentially. Our results have shown that the rate of metabolism of 13C-1 pyruvate to lactate in brain is high in the young mouse and decreases with age. The brain at P18 is still relatively immature and continues to develop even as the total brain volume remains the same.

Cognition, structural brain changes and complicated grief. A population-based study

2014 ◽  
Vol 45 (7) ◽  
pp. 1389-1399 ◽  
Author(s):  
H. C. Saavedra Pérez ◽  
M. A. Ikram ◽  
N. Direk ◽  
H. G. Prigerson ◽  
R. Freak-Poli ◽  
...  
Keyword(s):  
White Matter ◽  
Brain Volume ◽  
Complicated Grief ◽  
Population Based ◽  
Word Fluency ◽  
Total Brain Volume ◽  
Population Based Study ◽  
Total Brain ◽  
Fluency Task ◽  
Structural Brain

BackgroundSeveral psychosocial risk factors for complicated grief have been described. However, the association of complicated grief with cognitive and biological risk factors is unclear. The present study examined whether complicated grief and normal grief are related to cognitive performance or structural brain volumes in a large population-based study.MethodThe present research comprised cross-sectional analyses embedded in the Rotterdam Study. The study included 5501 non-demented persons. Participants were classified as experiencing no grief (n = 4731), normal grief (n = 615) or complicated grief (n = 155) as assessed with the Inventory of Complicated Grief. All persons underwent cognitive testing (Mini-Mental State Examination, Letter–Digit Substitution Test, Stroop Test, Word Fluency Task, word learning test – immediate and delayed recall), and magnetic resonance imaging to measure general brain parameters (white matter, gray matter), and white matter lesions. Total brain volume was defined as the sum of gray matter plus normal white matter and white matter lesion volume. Persons with depressive disorders were excluded and analyses were adjusted for depressive symptoms.ResultsCompared with no-grief participants, participants with complicated grief had lower scores for the Letter–Digit Substitution Test [Z-score −0.16 v. 0.04, 95% confidence interval (CI) −0.36 to −0.04, p = 0.01] and Word Fluency Task (Z-score −0.15 v. 0.03, 95% CI −0.35 to −0.02, p = 0.02) and smaller total volumes of brain matter (933.53 ml v. 952.42 ml, 95% CI −37.6 to −0.10, p = 0.04).ConclusionsParticipants with complicated grief performed poorly in cognitive tests and had a smaller total brain volume. Although the effect sizes were small, these findings suggest that there may be a neurological correlate of complicated grief, but not of normal grief, in the general population.

Abstract TP291: Hematoma Retraction and Perihematoma Hypodensity in Neutral Brain Model of Intracerebral Hemorrhage

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Shahram Majidi ◽  
Basit Rahim ◽  
Sarwat I Gilani ◽  
Waqas I Gilani ◽  
Malik M Adil ◽  
...  
Keyword(s):  
Biological Activity ◽  
Intracerebral Hemorrhage ◽  
Ct Scan ◽  
Early Period ◽  
Ct Scans ◽  
Hematoma Expansion ◽  
Human Cadaver ◽  
Fresh Blood ◽  
The Right

Background: The temporal evolution of intracerebral hematomas and perihematoma edema in the ultra-early period on computed tomographic (CT) scans in patients with intracerebral hemorrhage (ICH) is not well understood. We aimed to investigate hematoma and perihematoma changes in “neutral brain” models of ICH. Methods: One human and 6 goat cadaveric heads were used as “neutral brains” to provide physical properties of the brain without any biological activity or new bleeding. ICH was induced by slow injection of 4 ml of fresh blood into the right basal ganglia of the goat brains. Similarly, 20 ml of fresh blood was injected deep into the white matter of the human cadaver head in each hemisphere. Serial CT scans of the heads were performed at 0, 1, 3, and 5 hours after inducing ICH. Analyze software (AnalyzeDirect, Overland Park, KS) was used to measure hematoma and perihematoma hypodensity volumes in the baseline and follow up CT scans. Results: The initial hematoma volumes of 11.6 ml and 10.5 ml in the right and the left hemispheres of the human cadaver brain gradually decreased to 6.6 ml and 5.4 ml at 5 hours, showing 43% and 48% retraction of hematoma, respectively. The volume of the perihematoma hypodensity in the right and left hemisphere increased from 2.6 ml and 2.2 ml in the 1 hour follow up CT scans to 4.9 ml and 4.4 ml in the 5 hour CT scan, respectively. Hematoma retraction was also observed in all six ICH models in the goat brains. The mean ICH volume in the goat heads was decreased from 1.49 ml in the baseline CT scan to 1.01 ml in the 5 hour follow up CT scan showing 29.6% hematoma retraction. Perihematoma hypodensity was visualized in 70% of ICH in goat brains, with an increasing mean hypodensity volume of 0.4 ml in the baseline CT scan to 0.8 ml in the 5 hour follow up CT scan. Conclusion: Our study demonstrated that substantial hematoma retraction and perihematoma hypodensity occurs in intracerebral hematomas in the absence of any new bleeding or biological activity of the surrounding brain. Such observations suggest that active bleeding is underestimated in patients with no or small hematoma expansion and our understanding of perihematoma hypodesity needs to be reconsidered.

scholarly journals Atrial Fibrillation and Brain Magnetic Resonance Imaging Abnormalities

Stroke ◽  
2019 ◽  
Vol 50 (4) ◽  
pp. 783-788 ◽  
Author(s):  
Jeremy P. Berman ◽  
Faye L. Norby ◽  
Thomas Mosley ◽  
Elsayed Z. Soliman ◽  
Rebecca F. Gottesman ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Brain Volume ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
White Matter Hyperintensity ◽  
Resonance Imaging ◽  
Total Brain Volume ◽  
Cross Sectional ◽  
Total Brain ◽  
Sectional Analysis

Background and Purpose— Atrial fibrillation (AF) is associated with dementia independent of clinical stroke. The mechanisms underlying this association remain unclear. In a community-based cohort, the ARIC study (Atherosclerosis Risk in Communities), we evaluated (1) the longitudinal association of incident AF and (2) the cross-sectional association of prevalent AF with brain magnetic resonance imaging (MRI) abnormalities. Methods— The longitudinal analysis included 963 participants (mean age, 73±4.4 years; 62% women; 51% black) without prevalent stroke or AF who underwent a brain MRI in 1993 to 1995 and a second MRI in 2004 to 2006 (mean, 10.6±0.8 years). Outcomes included subclinical cerebral infarctions, sulcal size, ventricular size, and, for the cross-sectional analysis, white matter hyperintensity volume and total brain volume. Results— In the longitudinal analysis, 29 (3.0%) participants developed AF after the first brain MRI. Those who developed AF had higher odds of increase in subclinical cerebral infarctions (odds ratio [OR], 3.08; 95% CI, 1.39–6.83), worsening sulcal grade (OR, 3.56; 95% CI, 1.04–12.2), and worsening ventricular grade (OR, 9.34; 95% CI, 1.24–70.2). In cross-sectional analysis, of 969 participants, 35 (3.6%) had prevalent AF at the time of the 2004 to 2006 MRI scan. Those with AF had greater odds of higher sulcal (OR, 3.9; 95% CI, 1.7–9.1) and ventricular grade (OR, 2.4; 95% CI, 1.0–5.7) after multivariable adjustment and no difference in white matter hyperintensity or total brain volume. Conclusions— AF is independently associated with increase in subclinical cerebral infarction and worsening sulcal and ventricular grade—morphological changes associated with aging and dementia. More research is needed to define the mechanisms underlying AF-related neurodegeneration.

Is Total Brain Volume Correlated to Cognitive Function and Education in Patients with Alzheimer Disease?

2008 ◽  
Vol 21 (4) ◽  
pp. 500-504 ◽  
Author(s):  
P. Papapostolou ◽  
F. Goutsaridou ◽  
M. Arvaniti ◽  
M. Emmanouilidou ◽  
G. Tezapsidis ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Alzheimer Disease ◽  
Brain Volume ◽  
Total Brain Volume ◽  
Total Brain

The angiographically occult cerebrovascular malformation

1978 ◽  
Vol 48 (2) ◽  
pp. 292-296 ◽  
Author(s):  
James B. Golden ◽  
Richard A. Kramer
Keyword(s):  
Intracerebral Hemorrhage ◽  
Ct Scan ◽  
Vascular Malformation ◽  
Ct Scans ◽  
Cerebral Lesions ◽  
Content Type ◽  
Surgical Exploration ◽  
Diagnostic Possibility ◽  
Cerebrovascular Malformation ◽  
Fine Print

✓ Three cases presenting with hemiparesis, headache, or seizures gave no history suggestive of subarachnoid or intracerebral hemorrhage. Carotid arteriograms were performed, and in each case failed to demonstrate a vascular malformation. In all three cases cerebral lesions were shown by either computerized tomographic (CT) scan, radionuclide scan, or both. Surgical exploration and biopsy revealed a vascular malformation in each case. The CT scans in two of the cases showed dense lesions that could suggest vascular malformation as a diagnostic possibility.

scholarly journals Higher Serum 25-Hydroxyvitamin D and Lower Plasma Glucose Are Associated with Larger Gray Matter Volume but Not with White Matter or Total Brain Volume in Dutch Community-Dwelling Older Adults

2015 ◽  
Vol 145 (8) ◽  
pp. 1817-1823 ◽  
Author(s):  
Elske M Brouwer-Brolsma ◽  
Nikita L van der Zwaluw ◽  
Janneke P van Wijngaarden ◽  
Rosalie A Dhonukshe-Rutten ◽  
Paulette H in 't Veld ◽  
...  
Keyword(s):  
Brain Volume ◽  
Gray Matter Volume ◽  
Community Dwelling ◽  
Lower Plasma ◽  
Total Brain Volume ◽  
Hydroxyvitamin D ◽  
Total Brain ◽  
Lower Plasma Glucose ◽  
25 Hydroxyvitamin D ◽  
Community Dwelling Older Adults

scholarly journals The Bidirectional Association between Reduced Cerebral Blood Flow and Brain Atrophy in the General Population

2015 ◽  
Vol 35 (11) ◽  
pp. 1882-1887 ◽  
Author(s):  
Hazel I Zonneveld ◽  
Elizabeth A Loehrer ◽  
Albert Hofman ◽  
Wiro J Niessen ◽  
Aad van der Lugt ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Brain Atrophy ◽  
Brain Volume ◽  
Brain Magnetic Resonance Imaging ◽  
Community Dwelling ◽  
Linear Regression Models ◽  
Total Brain Volume ◽  
Total Brain ◽  
Bidirectional Association

The question remains whether reduced cerebral blood flow (CBF) leads to brain atrophy or vice versa. We studied the longitudinal relation between CBF and brain volume in a community-dwelling population. In the Rotterdam Study, 3011 participants (mean age 59.6 years (s.d. 8.0)) underwent repeat brain magnetic resonance imaging to quantify brain volume and CBF at two time points. Adjusted linear regression models were used to investigate the bidirectional relation between CBF and brain volume. We found that smaller brain volume at baseline was associated with a steeper decrease in CBF in the whole population (standardized change per s.d. increase of total brain volume (TBV) = 0.296 (95% confidence interval (CI) 0.200; 0.393)). Only in persons aged ≥ 65 years, a lower CBF at baseline was associated with steeper decline of TBV (standardized change per s.d. increase of CBF = 0.003 (95% CI −0.004; 0.010) in the whole population and 0.020 (95% CI 0.004; 0.036) in those aged ≥65 years of age). Our results indicate that brain atrophy causes CBF to decrease over time, rather than vice versa. Only in persons aged >65 years of age did we find lower CBF to also relate to brain atrophy.

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