Metode Pengukuran Volume Perdarahan Pemeriksaan MSCT Kepala pada Kasus Intraserebral Hemmorhage

Background: Intracerebral hemorrhage is bleeding in the brain parenchyma. An accurate measurement of bleeding volume to determine the appropriate medical action. This study to determine the method of measuring the volume of intracerebral hemorrhage in MSCT examination of the head and determine the advantages and disadvantages between the manual method (Broderick, ABC's, Ellipsoid) and the software method (automatic volume, otsu).Methods: This type of descriptive qualitative research with the Literature Review. Data obtained by identifying problems then searching for keywords, looking for several journals sourced from databases such as Google Scholar, Science Direct, Springer. Data analysis by studying theoretically the method of measuring the volume of bleeding methods manually (Broderick, ABC’s, ellipsoid) and using software methods (automatic volume, otsu).Results: The results of measuring the volume of bleeding in the same patient with the manual method (Broderick) produce more bleeding volume (overestimate) that is 8750 mm3 from the 7960 mm3 automatic volume method. The manual method (Broderick, ABC’s, Ellipsoid) uses the ABC / 2 formula and uses 5 mm slice thickness, the automatic volume software method uses 1 mm slice thickness segmentation and technique, while the otsu software method uses 2.5 mm segmentation and slice thickness techniques.Conclusion: The advantages of the manual method (Broderick, ABC’s, ellipsoid) take approximately 1 minute to determine the estimated outcome of the bleeding volume, the weakness is higher in irregular bleeding. The advantages of the software method (automatic volume, otsu) in the use of precise segmentation techniques for accurate volume results, weaknesses are too long in determining the estimated bleeding volume results.

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Abstract 178: Cholesterol Limits Macrophage Activation in Response to Intracerebral Hemorrhage-Relevant Signals

Stroke ◽

10.1161/str.51.suppl_1.178 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Jonathan H DeLong ◽

Sofia Velazquez ◽

Margaret J Landreneau ◽

Lauren H Sansing

Keyword(s):

Intracerebral Hemorrhage ◽

Macrophage Activation ◽

Cholesterol Content ◽

Brain Parenchyma ◽

Activation Markers ◽

Multiple Systems ◽

Murine Bone Marrow ◽

Inflammatory Phenotype ◽

Injury Models ◽

The Brain

Introduction: In response to intracerebral hemorrhage (ICH), monocytes are recruited to the brain parenchyma, where they differentiate into macrophages and contribute to a pathological inflammatory response. However, by day 3 after ICH, brain macrophages have adopted a more reparative phenotype and are important for clearance of apoptotic cells and recovery. The signals that control this inflammatory to reparative differentiation are incompletely understood, but cholesterol has been found to limit macrophage activation in multiple systems. The brain has the highest cholesterol content of any organ and we hypothesized that cholesterol uptake by macrophages limits inflammation and promotes the development of reparative macrophages following ICH. Methods and Results: Murine bone marrow-derived macrophages were stimulated with a cocktail of thrombin, S100A8, and IL-1b in order to mimic the Danger-Associated Molecular Patterns present in the brain after ICH (ICH-DAMP), LPS, or vehicle for 14-18 hours. Cytokine production was quantified by cytometric bead array and activation markers by flow cytometry. ICH-DAMP was found to upregulate CCL2, IL-6 and TNF, recapitulating the inflammatory phenotype seen in the first days after ICH. However, when cells were stimulated in the presence of cholesterol, production of CCL2, IL-6, and TNF were limited. Dectin-1 has inhibitory properties in some sterile injury models. ICH-DAMP was found to limit expression of dectin-1, and cholesterol reversed this inhibition. Exposure to exogenous cholesterol also upregulated the cholesterol transporter ABCA1, allowing cells to efflux excess cholesterol. The drug Valspodar was therefore used to block cholesterol efflux and was found to further limit ICH-DAMP-mediated upregulation of CCL2. Conclusion: These results suggest that the cholesterol in the brain may limit macrophage activation in response to the stimuli present during intracerebral hemorrhage.

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Hypoxia-Inducible Factor-1α Accumulation in the Brain after Experimental Intracerebral Hemorrhage

Journal of Cerebral Blood Flow & Metabolism ◽

10.1097/00004647-200206000-00007 ◽

2002 ◽

Vol 22 (6) ◽

pp. 689-696 ◽

Cited By ~ 49

Author(s):

Yajun Jiang ◽

Jimin Wu ◽

Richard F. Keep ◽

Ya Hua ◽

Julian T. Hoff ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Messenger Rna ◽

Hypoxia Inducible Factor ◽

Early Response ◽

Brain Parenchyma ◽

Thrombin Inhibitor ◽

Sprague Dawley ◽

Time Points ◽

Autologous Whole Blood ◽

The Brain

Hypoxia-inducible factor-1 (HIF-1), a transcription factor composed of HIF-1α and HIF-1β protein subunits, has been implicated in cellular protection and cell death in cerebral ischemia. The extent to which HIF-1 plays a role in brain pathology during intracerebral hemorrhage (ICH) is unknown. This study determined whether HIF-1α is upregulated at different time points in a rat model of ICH and the role of thrombin and red blood cell lysis in upregulation. Recently, thrombin has been implicated as a nonhypoxic regulator of HIF-1α in cultured smooth-muscle cells. Male Sprague-Dawley rats received intracerebral infusions of saline, autologous whole blood, blood plus hirudin, thrombin, thrombin plus hirudin, or lysed erythrocytes. Rats were killed at different time points for Western blot analysis, immunohistochemistry, immunofluorescent double staining, and reverse transcription polymerase chain reaction measurements of HIF-1α. HIF-1α protein levels increased without changing HIF-1α messenger RNA levels after intracerebral infusions of blood, thrombin, and lysed erythrocytes. HIF-1α positive cells, which proved to be neurons, were found in the brain after ICH. Hirudin, a specific thrombin inhibitor, reduced HIF-1α upregulation in response to both thrombin and blood. This study demonstrates that perihematomal HIF-1α protein is upregulated after ICH. This phenomenon is an early response of brain parenchyma to the clot. Thrombin and erythrocyte lysate are involved in HIF-1α upregulation through reducing HIF-1α degradation.

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The Correlation Between Age and Bleeding Volume in Haemorrhagic Stroke Using Multi Slice CT at District Hospitals in Jakarta

Global Journal of Health Science ◽

10.5539/gjhs.v8n4p152 ◽

2015 ◽

Vol 8 (4) ◽

pp. 152 ◽

Cited By ~ 1

Author(s):

Tatan Saefudin ◽

Nursama Heru Apriantoro ◽

Ekaputra Syarif Hidayat ◽

Schandra Purnamawati

Keyword(s):

Imaging Modality ◽

Secondary Data ◽

Haemorrhagic Stroke ◽

Common Disease ◽

Slice Thickness ◽

Cross Sectional ◽

Bleeding Volume ◽

District Hospitals ◽

Computed Tomography Scanning ◽

The Brain

Haemorrhagic Stroke is a common disease in Indonesia. The best imaging modality for this disease is Multi Slice Computed Tomography Scanning (MSCT), as it may help strengthening the diagnosis as well as determining the brain bleeding volume. This study aimed to show correlation between bleeding volume of the brain and patient’s age using cross-sectional approach. The 68 samples in this study were taken from secondary data from Head CT Scan of Haemorrhagic Stroke cases. Brain bleeding volume is the dependent variable, obtained through slice thickness of 5 mm and ABC/2 method with software measurement in MSCT Scan device. The independent variable of this study is the patient’s age. The result of the study was the average brain’s bleeding volume of 21.76 ml ± 2.48 ml (range of 1.04 ml to 94.73 ml).The slice thickness using ABC/2 method, has a significant correlation with brain’s bleeding volume in MSCT Scan examination, with correlation coefficient value r of 0.79. Brain bleeding volume in patients who have ages lower than 50 years and more or equal to 50 years were (18.93 ± 3.26) ml and (23.53 ± 3.47) ml respectively. There is no correlation between age and brain’s bleeding volume in haemorrhagic stroke cases, with p value of 0.18, r = 0.19.

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Intracerebral Hemorrhage: Blood Components and Neurotoxicity

Brain Sciences ◽

10.3390/brainsci9110316 ◽

2019 ◽

Vol 9 (11) ◽

pp. 316 ◽

Cited By ~ 5

Author(s):

Neha Madangarli ◽

Frederick Bonsack ◽

Rajaneekar Dasari ◽

Sangeetha Sukumari–Ramesh

Keyword(s):

Intracerebral Hemorrhage ◽

Public Health Problem ◽

Brain Parenchyma ◽

Neurological Deficits ◽

Blood Component ◽

Major Public Health Problem ◽

Blood Components ◽

Secondary Brain Damage ◽

Mortality And Morbidity ◽

The Brain

Intracerebral hemorrhage (ICH) is a subtype of stroke which is associated with the highest mortality and morbidity rates of all strokes. Although it is a major public health problem, there is no effective treatment for ICH. As a consequence of ICH, various blood components accumulate in the brain parenchyma and are responsible for much of the secondary brain damage and ICH-induced neurological deficits. Therefore, the strategies that could attenuate the blood component-induced neurotoxicity and improve hematoma resolution are highly needed. The present article provides an overview of blood-induced brain injury after ICH and emphasizes the need to conduct further studies elucidating the mechanisms of hematoma resolution after ICH.

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The Role of Urocortins in Intracerebral Hemorrhage

Biomolecules ◽

10.3390/biom10010096 ◽

2020 ◽

Vol 10 (1) ◽

pp. 96 ◽

Cited By ~ 1

Author(s):

Ker Woon Choy ◽

Andy Po-Yi Tsai ◽

Peter Bor-Chian Lin ◽

Meng-Yu Wu ◽

Chihyi Lee ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Brain Regions ◽

Brain Parenchyma ◽

Protective Mechanisms ◽

Neuroprotective Effects ◽

Blood Brain Barrier Disruption ◽

Brain Barrier Disruption ◽

G Protein Coupled ◽

The Brain

Intracerebral hemorrhage (ICH) causes an accumulation of blood in the brain parenchyma that disrupts the normal neurological function of the brain. Despite extensive clinical trials, no medical or surgical therapy has shown to be effective in managing ICH, resulting in a poor prognosis for the patients. Urocortin (UCN) is a 40-amino-acid endogenous neuropeptide that belongs to the corticotropin-releasing hormone (CRH) family. The effect of UCN is activated by binding to two G-protein coupled receptors, CRH-R1 and CRH-R2, which are expressed in brain neurons and glial cells in various brain regions. Current research has shown that UCN exerts neuroprotective effects in ICH models via anti-inflammatory effects, which generally reduced brain edema and reduced blood-brain barrier disruption. These effects gradually help in the improvement of the neurological outcome, and thus, UCN may be a potential therapeutic target in the treatment of ICH. This review summarizes the data published to date on the role of UCN in ICH and the possible protective mechanisms underlined.

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Experimental study of high-resolution ultrasound imaging of hemorrhage, bone fragments, and foreign bodies in head trauma

Journal of Neurosurgery ◽

10.3171/jns.1981.54.3.0304 ◽

1981 ◽

Vol 54 (3) ◽

pp. 304-309 ◽

Cited By ~ 21

Author(s):

Dieter R. Enzmann ◽

Richard H. Britt ◽

Bernie Lyons ◽

T. L. Buxton ◽

D. A. Wilson

Keyword(s):

High Resolution ◽

Intracerebral Hemorrhage ◽

Head Trauma ◽

Foreign Bodies ◽

Intraoperative Imaging ◽

Ultrasound Image ◽

Brain Parenchyma ◽

Content Type ◽

High Resolution Ultrasonography ◽

The Brain

✓ The accuracy of high-resolution ultrasound scans in detecting foreign bodies and hemorrhage within the brain was evaluated by comparison with computerized tomography (CT) scans and gross pathology. The test lesions were blood and foreign bodies consisting of bone, wood, and metal placed in the brain of an experimental animal. High-resolution ultrasound scans (10 MHz) performed in coronal and sagittal planes accurately delineated the position and spatial orientation of these foreign bodies and hemorrhage. Both hemorrhage and foreign bodies were echogenic compared to normal, hypoechoic brain parenchyma. Metal fragments had a highly characteristic echo pattern caused by sound reverberation within the object. Acute intracerebral hemorrhage produced an ultrasound image consisting of sharply circumscribed homogeneous echoes. The sonographic shape of intracerebral hemorrhage correlated closely with the area of increased density seen on the CT scan. High-resolution ultrasonography accurately delineated experimentally produced components of head trauma and may prove useful as an intraoperative imaging technique to facilitate surgery in head-injured patients.

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Hydrocephalus in dogs: a review

Veterinární Medicína ◽

10.17221/6698-vetmed ◽

2013 ◽

Vol 58 (No. 2) ◽

pp. 73-80 ◽

Cited By ~ 5

Author(s):

P. Przyborowska ◽

Z. Adamiak ◽

M. Jaskolska ◽

Y. Zhalniarovich

Keyword(s):

Clinical Symptoms ◽

Imaging Techniques ◽

Spin Echo ◽

Brain Area ◽

Volume Ratio ◽

Diagnostic Methods ◽

Slice Thickness ◽

Advantages And Disadvantages ◽

Mri Scans ◽

The Brain

Hydrocephalus is a multifactoral disorder that was rarely diagnosed in dogs until the availability of advanced imaging techniques in veterinary practice. This article reviews recent advances in the understanding of canine hydrocephalus including pathogenesis, clinical symptoms, diagnostic methods, and treatment solutions. The advantages and disadvantages of USG, RTG, CT and MRI as advanced diagnostic methods are discussed. For now Low-field Magnetic Resonance Imaging is the most useful tool in investigating hydrocephalus. The recommended sequences for MRI are T1-weighting images Spin echo, Field echo 3D with TR 380–750 ms, TE 12–25 ms, slice thickness 1–6 mm and with an interslice gap of 0–2 mm. The evaluation of cerebral ventricular system morphology in obtained MRI scans involves measuring the height, area and volume of the brain and lateral ventricles. The results are classified as normal state if the ratio of ventricular height to the brain height is above 14%, the ratio of ventricular area to the brain area amounts to above 7%, and the ventricular to brain volume ratio is above 5%. However, there are still problems relating to inter- and intrabreed comparison among examined dogs. Treatment solutions in hydrocephalus are also discussed in this review. The medical treatment of hydrocephalus aims to decrease CSF production and is based on using acetazolamide, furosemide and prednisone. Surgical management aims to place the ventriculoperitoneal shunt for CSF flow control. Postsurgical complications are also described in this review.  

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Low incidence of delayed intracerebral hemorrhage secondary to ventriculoperitoneal shunt insertion

Journal of Neurosurgery ◽

10.3171/jns.1999.91.1.0032 ◽

1999 ◽

Vol 91 (1) ◽

pp. 32-34 ◽

Cited By ~ 31

Author(s):

Martin H. Savitz ◽

Lewis M. Bobroff

Keyword(s):

Intracerebral Hemorrhage ◽

Brain Parenchyma ◽

Adult Patients ◽

Vascular Lesions ◽

Intracerebral Hematoma ◽

Shunt Insertion ◽

Content Type ◽

Vp Shunt ◽

The Brain ◽

Fine Print

Object. Bleeding into the brain parenchyma or ventricles is an infrequently reported complication in adults who undergo insertion of a ventriculoperitoneal (VP) shunt. The purpose of this study was to establish the incidence of delayed intracerebral hemorrhage secondary to ventricular cannulation during shunting procedures.Methods. Over a 24-year period, in a series of 125 adult patients with hydrocephalus, postoperative computerized tomography scans were obtained in every case within 48 hours of shunt surgery performed by the same neurosurgeon. The rate of delayed intracerebral hematoma or intraventricular hemorrhage after VP shunt placement was documented by routine neuroradiological follow up to be 4%.Conclusions. In adult patients with no coagulopathy or occult vascular lesions, the rate of bleeding after VP shunt insertion may be low if the procedure is uncomplicated by multiple attempts at perforation, puncture of the choroid plexus, or improper placement of the tubing within the parenchyma of the brain.

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Penghitungan Volumetrik Perdarahan dengan Metode Volume Automatik (Software Volume Evaluation) dan Metode Manual (Broderick) pada MSCT Kepala (Study Eksperimen pada Pasien Perdarahan Intraserebral di RS. Haji Surabaya)

Jurnal Imejing Diagnostik (JImeD) ◽

10.31983/jimed.v3i2.3190 ◽

2017 ◽

Vol 3 (2) ◽

pp. 231-235

Author(s):

Agus Setyo Kiswoyo ◽

Gatot Murti Wibowo ◽

Widiana Ferriastuti

Keyword(s):

Intracerebral Hemorrhage ◽

Ct Scan ◽

Quantitative Research ◽

Clinical Symptoms ◽

P Value ◽

Volume Calculation ◽

Manual Method ◽

Risk Of Death ◽

Significant Difference ◽

Volume Method

Background : Intracerebral hemorrhage (ICH) is the brain parenchyma bleeding. The volume of intracerebral hemorrhage can affect mild to severe clinical symptoms due to increased intracranial pressure and it has a high risk of death. In addition, CT scan CTScan is a gold standard on PIS examination. Methods : This was a quantitative research with experimental approach. There are two methods of volumetric hemorrhage calculation, namely automatic and manual method. Automatic Volume Method (SVE) is a volume calculation by computer software available on CT Scan tool with voxel calculation in HU value range. The manual method (Broderick) used is AXBXC/2 which is the multiplication of length (A), width (B) and height/thickness of bleeding slice (C) divided by 2. From the result, the volume differencewas tabulated and measured, then the normality and different test were done.Results : The sample consisted of 10 new bleeding patient data which then classified into small hemorrhage group, calculated volumes automatic(SVE) and manual(Broderick). volume calculations obtained different values of volume ranging from 0.37 cm³ to 10.01 cm³, the percentage ranged from 3% to 41%. The result showed a very significant difference value due to the different test Paired Samples T Test with significance value of 0.001 (p-Value 0.05). From the data, 8 patients with different percentage above 20%,with average 25% were PIS with irregular shape. And 2 patients with volume difference below 10% with average 6 % were Intracerebral Hemorrhage regular shape. Conclussions : There is a difference in the calculation of volumetric Intracerebral hemorrhage between the automatic volume method (SVE) and the manual method (Broderick). With a percentage average difference of average volume of 6% for regular shapes and 25% for irregular hemorrhage.

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Intracerebral hemorrhage: update and future directions

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20200088 ◽

2020 ◽

Vol 78 (10) ◽

pp. 651-659

Author(s):

Eva ROCHA ◽

Carolina ROUANET ◽

Danyelle REGES ◽

Vivian GAGLIARDI ◽

Aneesh Bhim SINGHAL ◽

...

Keyword(s):

Intracerebral Hemorrhage ◽

Surgical Techniques ◽

Treatment Strategies ◽

Pressure Control ◽

Brain Parenchyma ◽

Public Health Issue ◽

Future Directions ◽

Minimally Invasive Surgical ◽

Significant Public Health ◽

The Brain

ABSTRACT Intracerebral hemorrhage (ICH), defined as bleeding into the brain parenchyma, is a significant public health issue. Although it accounts for only 10 to 15% of strokes, it is associated with the highest morbidity and mortality rates. Despite advances in the field of stroke and neurocritical care, the principles of acute management have fundamentally remained the same over many years. The main treatment strategies include aggressive blood pressure control, early hemostasis, reversal of coagulopathies, clot evacuation through open surgical or minimally invasive surgical techniques, and the management of raised intracranial pressure.

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