Predictors of early neurological deterioration in patients with spontaneous intracerebral hemorrhage

2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Ahmed Abdelwahab ◽  
Amr Kamel ◽  
wafaa mohamed ◽  
Mohammed Mahdy
Keyword(s):  
Intracerebral Hemorrhage ◽  
Neurological Deterioration ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Early Neurological Deterioration

scholarly journals High neutrophil-to-lymphocyte ratio predicts early neurological deterioration in spontaneous intracerebral hemorrhage patients

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Wafaa S. Mohamed ◽  
Amr E. Kamel ◽  
Ahmed H. Abdelwahab ◽  
Mohamed E. Mahdy
Keyword(s):  
Intracerebral Hemorrhage ◽  
Complete Blood Count ◽  
Absolute Lymphocyte Count ◽  
Neurological Deterioration ◽  
University Hospital ◽  
Stroke Severity ◽  
Low Grade ◽  
Nihss Score ◽  
Early Neurological Deterioration ◽  
Gcs Score

Abstract Background Intracerebral hemorrhage (ICH) is caused by bleeding, primarily into parenchymal brain tissue, and accounts for 9 to 27% of all strokes worldwide. Higher neutrophils, lower lymphocytes, and higher neutrophil-to-lymphocytes ratio (NLR) values predict worse outcomes after spontaneous intracranial hemorrhage (sICH) and could aid in the risk stratification of patients. Methods Eighty patients with sICH within the first 24 h of stroke onset and admitted into the neurology intensive care unit of an Egyptian university hospital and were assessed by GCS for consciousness level and NIHSS for stroke severity assessment, complete blood count, and special attention to NLR. Patients were reevaluated by GCS and NIHSS on the 7th day of the stroke. Early neurological deterioration (END) was defined as four points or a greater increase in the NIHSS score or two points or a greater decrease in GCS or death. Results END was recorded in 21.25% of patients while non-END was recorded in 78.75%. END was highly significantly associated with a low grade of GCS, high grade of NIHSS, elevated absolute lymphocyte count (ALC), and elevated NLR. Lower GCS score, higher NIHSS score, larger hematoma volume, and higher NLR values were independent predictors for END. The best cutoff of NLR in END prediction was > 9.1. Conclusion NLR is a trustworthy early predictor of sICH outcome.

scholarly journals Predictors and Outcomes of Neurological Deterioration in Intracerebral Hemorrhage: Results from the TICH-2 Randomized Controlled Trial

2020 ◽  
Author(s):  
Zhe Kang Law ◽  
◽  
Rob Dineen ◽  
Timothy J England ◽  
Lesley Cala ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Intracerebral Hemorrhage ◽  
Tranexamic Acid ◽  
Controlled Trial ◽  
Neurological Deterioration ◽  
Unique Identifier ◽  
Risk Of Death ◽  
Randomized Controlled ◽  
Early Neurological Deterioration ◽  
The Uk

Abstract Neurological deterioration is common after intracerebral hemorrhage (ICH). We aimed to identify the predictors and effects of neurological deterioration and whether tranexamic acid reduced the risk of neurological deterioration. Data from the Tranexamic acid in IntraCerebral Hemorrhage-2 (TICH-2) randomized controlled trial were analyzed. Neurological deterioration was defined as an increase in National Institutes of Health Stroke Scale (NIHSS) of ≥ 4 or a decline in Glasgow Coma Scale of ≥ 2. Neurological deterioration was considered to be early if it started ≤ 48 h and late if commenced between 48 h and 7 days after onset. Logistic regression was used to identify predictors and effects of neurological deterioration and the effect of tranexamic acid on neurological deterioration. Of 2325 patients, 735 (31.7%) had neurological deterioration: 590 (80.3%) occurred early and 145 (19.7%) late. Predictors of early neurological deterioration included recruitment from the UK, previous ICH, higher admission systolic blood pressure, higher NIHSS, shorter onset-to-CT time, larger baseline hematoma, intraventricular hemorrhage, subarachnoid extension and antiplatelet therapy. Older age, male sex, higher NIHSS, previous ICH and larger baseline hematoma predicted late neurological deterioration. Neurological deterioration was independently associated with a modified Rankin Scale of > 3 (aOR 4.98, 3.70–6.70; p < 0.001). Tranexamic acid reduced the risk of early (aOR 0.79, 0.63–0.99; p = 0.041) but not late neurological deterioration (aOR 0.76, 0.52–1.11; p = 0.15). Larger hematoma size, intraventricular and subarachnoid extension increased the risk of neurological deterioration. Neurological deterioration increased the risk of death and dependency at day 90. Tranexamic acid reduced the risk of early neurological deterioration and warrants further investigation in ICH. URL:https://www.isrctn.com Unique identifier: ISRCTN93732214

scholarly journals Correlation of leukocytosis with early neurological deterioration following supratentorial intracerebral hemorrhage

2012 ◽  
Vol 19 (8) ◽  
pp. 1096-1100 ◽  
Author(s):  
Wei Sun ◽  
Amanda Peacock ◽  
Jane Becker ◽  
Barbara Phillips-Bute ◽  
Daniel T. Laskowitz ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Neurological Deterioration ◽  
Early Neurological Deterioration

scholarly journals Predictors of Late Neurological Deterioration After Spontaneous Intracerebral Hemorrhage

2013 ◽  
Vol 19 (3) ◽  
pp. 299-305 ◽  
Author(s):  
Weiping Sun ◽  
Wenqin Pan ◽  
Peter G. Kranz ◽  
Claire E. Hailey ◽  
Rachel A. Williamson ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Neurological Deterioration ◽  
Spontaneous Intracerebral Hemorrhage

Abstract WP228: Imaging Findings Associated With Ultra-Early Neurological Deterioration in EMS-Transported Intracerebral Hemorrhage Patients

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Kristina Shkirkova ◽  
Pitchamol Vilaisaktipakorn ◽  
Pablo Villablanca ◽  
Gregory Wong ◽  
Julius Weng ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Neurological Deterioration ◽  
Imaging Findings ◽  
Early Neurological Deterioration

scholarly journals Prognostic Value of Serum Concentration of Vascular Endothelial Growth Factor A in Patients in Acute Period of Spontaneous Supratentorial Intracerebral Hemorrhage

2021 ◽  
Vol 6 (2) ◽  
pp. 87-93
Author(s):  
A. A. Kuznietsov ◽  
Keyword(s):  
Vascular Endothelial Growth Factor ◽  
Growth Factor ◽  
Conservative Treatment ◽  
Intracerebral Hemorrhage ◽  
Intraventricular Hemorrhage ◽  
Neurological Deterioration ◽  
Vascular Endothelial ◽  
Acute Period ◽  
Early Neurological Deterioration ◽  
Endothelial Growth Factor

The aim of the study – to evaluate the informativeness of serum vascular endothelial growth factor A levels in detection of short-term prognosis in acute period of spontaneous supratentorial intracerebral hemorrhage on the ground of conservative treatment. Materials and methods. Prospective cohort comparative study of the 89 patients in acute period of spontaneous supratentorial intracerebral hemorrhage was done on the ground of conservative treatment. The evaluation of neurological deficit level was performed by using Full Outline of Unresponsiveness coma scale, Glasgow scale and National Institute of Health Stroke Scale. Cerebral brain structures visualization was made by computed tomography. During 24 hours of hospitalization serum samples were collected and vascular endothelial growth factor A (VEGF-A) was measures by using ELISA method. Early neurological deterioration and unfavorable acute spontaneous supratentorial intracerebral hemorrhage period outcome (4-6 score by modified Rankin scale on the 21st day of the disease) were registered as combined clinical endpoints. Statistical operation was made with the help of correlation analysis, logistic regression analysis, ROC-analysis. Results. Patients with unfavorable course and spontaneous supratentorial intracerebral hemorrhage acute period outcome were characterized by higher serum VEGF-A values on the 1st day from admission, that correlates with the volume of intracerebral hemorrhage (R=0,21, p˂0,01), volume of secondary intraventricular hemorrhage (R=0,29, p˂0,01) and total volume of intracranial hemorrhage (R=0,31, p˂0,01). It was detected that evaluation of VEGF-A serum concentrations together with neurovisualization parameters (midline shift severity, volume of secondary intraventricular hemorrhage) as a part of multipredictive logistic regression model allow to detect individual risk of early neurological deterioration with the accuracy 89,9% (AUC±SE (95% CI) = 0,91±0,04 (0,83-0,96), р˂0,0001). Conclusions. Serum VEGF-A levels in patients with spontaneous supratentorial intracerebral hemorrhage on the 1st day from admission is an informative additional parameter for prognosis of early neurological deterioration on the ground of conservative treatment

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