Temporal pattern of cytotoxic edema in the perihematomal region after intracerebral hemorrhage: a serial magnetic resonance imaging study
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Temporal pattern of cytotoxic edema in the perihematomal region after intracerebral hemorrhage: a serial magnetic resonance imaging study. / Li, Na; Worthmann, Hans; Heeren, Meike; Schuppner, Ramona; Deb-Chatterji, Milani; Tryc, Anita B; Bueltmann, Eva; Lanfermann, Heinrich; Donnerstag, Frank; Weissenborn, Karin; Raab, Peter.
In: STROKE, Vol. 44, No. 4, 04.2013, p. 1144-6.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Temporal pattern of cytotoxic edema in the perihematomal region after intracerebral hemorrhage: a serial magnetic resonance imaging study
AU - Li, Na
AU - Worthmann, Hans
AU - Heeren, Meike
AU - Schuppner, Ramona
AU - Deb-Chatterji, Milani
AU - Tryc, Anita B
AU - Bueltmann, Eva
AU - Lanfermann, Heinrich
AU - Donnerstag, Frank
AU - Weissenborn, Karin
AU - Raab, Peter
PY - 2013/4
Y1 - 2013/4
N2 - BACKGROUND AND PURPOSE: Knowledge about cytotoxic edema (CE) in intracerebral hemorrhage is still limited. We aimed to analyze its presence, temporal pattern, and prognostic meaning.METHODS: Twenty-one patients with primary intracerebral hemorrhage underwent magnetic resonance imaging at days 1, 3, and 7 after symptom onset. CE was identified using diffusion-weighted imaging. Hematoma and perihematomal edema volumes were measured on fluid-attenuated inversion recovery images. National Institutes of Health Stroke Scale score was assessed at admission and with each magnetic resonance imaging. Clinical outcome was assessed by modified Rankin scale at 90 days.RESULTS: CE appeared in half of the patients within the first 24 hours. The apparent diffusion coefficient values decreased until day 3 and were significantly reversed from days 3 through 7 (P<0.01). Patients with CE showed significantly faster perihematomal edema growth from day 0 to 1 (P=0.036) than those without. Larger 3-day perihematomal edema volume (P=0.02) and presence of CE on day 3 (P=0.07) were associated with poor clinical outcome.CONCLUSIONS: CE is associated with stroke severity, perihematomal edema volume, and poor outcome. It is considered to indicate ongoing neuronal injury and, thus, might emerge as new treatment target.
AB - BACKGROUND AND PURPOSE: Knowledge about cytotoxic edema (CE) in intracerebral hemorrhage is still limited. We aimed to analyze its presence, temporal pattern, and prognostic meaning.METHODS: Twenty-one patients with primary intracerebral hemorrhage underwent magnetic resonance imaging at days 1, 3, and 7 after symptom onset. CE was identified using diffusion-weighted imaging. Hematoma and perihematomal edema volumes were measured on fluid-attenuated inversion recovery images. National Institutes of Health Stroke Scale score was assessed at admission and with each magnetic resonance imaging. Clinical outcome was assessed by modified Rankin scale at 90 days.RESULTS: CE appeared in half of the patients within the first 24 hours. The apparent diffusion coefficient values decreased until day 3 and were significantly reversed from days 3 through 7 (P<0.01). Patients with CE showed significantly faster perihematomal edema growth from day 0 to 1 (P=0.036) than those without. Larger 3-day perihematomal edema volume (P=0.02) and presence of CE on day 3 (P=0.07) were associated with poor clinical outcome.CONCLUSIONS: CE is associated with stroke severity, perihematomal edema volume, and poor outcome. It is considered to indicate ongoing neuronal injury and, thus, might emerge as new treatment target.
KW - Brain
KW - Brain Edema
KW - Cerebral Hemorrhage
KW - Diffusion Magnetic Resonance Imaging
KW - Hematoma
KW - Humans
KW - Magnetic Resonance Imaging
KW - Neurons
KW - Prognosis
KW - Risk
KW - Stroke
KW - Time Factors
KW - Treatment Outcome
KW - Journal Article
U2 - 10.1161/STROKEAHA.111.000056
DO - 10.1161/STROKEAHA.111.000056
M3 - SCORING: Journal article
C2 - 23391767
VL - 44
SP - 1144
EP - 1146
JO - STROKE
JF - STROKE
SN - 0039-2499
IS - 4
ER -