预测脑出血血肿扩大研究进展
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摘要
自发性脑出血是死亡率最高的脑卒中,约1/3自发性脑出血患者会发生血肿扩大,提示预后不良。如在脑出血早期即可发现血肿扩大高风险患者,及时干预,可预防血肿扩大。血肿扩大的预测指标包括临床、实验室及影像学指标,对临床有效识别血肿扩大并进一步制定治疗方案有重要价值。本文对血肿扩大预测指标的预测效能及其可能机制进行综述。
Spontaneous cerebral hemorrhage is the most deadly form of stroke.About 1/3 patients with spontaneous cerebral hemorrhage undergo hematoma enlargement,which predicting a worse prognosis.If patients with high-risk of hematoma enlargement could be found and intervened in early stage,hematoma enlargement can be prevented.The predictors of hematoma enlargement include clinical index,laboratories index and imaging index,which are important for clinically effective identification of hematoma enlargement and further development of treatment options.The actual effectiveness of these predictive indicators and possible intrinsic pathogenesis were reviewed in this paper.
Spontaneous cerebral hemorrhage is the most deadly form of stroke.About 1/3 patients with spontaneous cerebral hemorrhage undergo hematoma enlargement,which predicting a worse prognosis.If patients with high-risk of hematoma enlargement could be found and intervened in early stage,hematoma enlargement can be prevented.The predictors of hematoma enlargement include clinical index,laboratories index and imaging index,which are important for clinically effective identification of hematoma enlargement and further development of treatment options.The actual effectiveness of these predictive indicators and possible intrinsic pathogenesis were reviewed in this paper.
引文
[1] Delcourt C, Huang Y, Arima H, et al. Hematoma growth and outcomes in intracerebral hemorrhage: The INTERACT1 study. Neurology, 2012,79(4):314-319.
[2] Flaherty ML, Haverbusch M, Sekar P, et al. Long-term mortality after intracerebral hemorrhage. Neurology, 2006,66(8):1182-1186.
[3] Fujii Y, Tanaka R, Takeuchi S, et al. Hematoma enlargement in spontaneous intracerebral hemorrhage. J Neurosurg, 1994,80(1):51-57.
[4] Kazui S, Naritomi H, Yamamoto H, et al. Enlargement of spontaneous intracerebral hemorrhage. Incidence and time course. Stroke, 1996,27(10):1783-1787.
[5] Brott T, Broderick J, Kothari R, et al. Early hemorrhage growth in patients with intracerebral hemorrhage. Stroke, 1997,28(1):1-5.
[6] Wang X, Arima H, Al-Shahi Salman R, et al. Clinical prediction algorithm (BRAIN) to determine risk of hematoma growth in acute intracerebral hemorrhage. Stroke, 2015,46(2):376-381.
[7] Brouwers HB, Chang Y, Falcone GJ, et al. Predicting hematoma expansion after primary intracerebral hemorrhage. JAMA Neurol, 2014,71(2):158-164.
[8] Koga M, Yamagami H, Okuda S, et al. Blood glucose levels during the initial 72 h and 3-month functional outcomes in acute intracerebral hemorrhage: The SAMURAI-ICH study. J Neurol Sci, 2015,350(1-2):75-78.
[9] Feng W, Tauhid S, Goel S, et al. Hyperglycemia and outcome in intracerebral hemorrhage: From bedside to bench-more study is needed. Transl Stroke Res, 2012,3(Suppl 1):113-118.
[10] Godoy DA, Di Napoli M, Rabinstein AA. Treating hyperglycemia in neurocritical patients: Benefits and perils. Neurocrit Care, 2010,13(3):425-438.
[11] Sakamoto Y, Koga M, Yamagami H, et al. Systolic blood pressure after intravenous antihypertensive treatment and clinical outcomes in hyperacute intracerebral hemorrhage: The stroke acute management with urgent risk-factor assessment and improvement-intracerebral hemorrhage study. Stroke, 2013,44(7):1846-1851.
[12] Qureshi AI, Palesch YY, Martin R, et al. Effect of systolic blood pressure reduction on hematoma expansion, perihematomal edema, and 3-month outcome among patients with intracerebral hemorrhage: Results from the antihypertensive treatment of acute cerebral hemorrhage study. Arch Neurol, 2010,67(5):570-576.
[13] Qureshi AI, Palesch YY, Barsan WG, et al. Intensive blood-pressure lowering in patients with acute cerebral hemorrhage. N Engl J Med, 2016,375(11):1033-1043.
[14] Huynh TJ, Aviv RI, Dowlatshahi D, et al. Validation of the 9-point and 24-point hematoma expansion prediction scores and derivation of the PREDICT A/B scores. Stroke, 2015,46(11):3105-3110.
[15] Cucchiara B, Messe S, Sansing L, et al. Hematoma growth in oral anticoagulant related intracerebral hemorrhage. Stroke, 2008,39(11):2993-2996.
[16] Di Napoli M, Parry-Jones AR, Smith CJ, et al. C-reactive protein predicts hematoma growth in intracerebral hemorrhage. Stroke, 2014,45(1):59-65.
[17] Dowlatshahi D, Brouwers HB, Demchuk AM, et al. Predicting intracerebral hemorrhage growth with the spot sign: The effect of onset-to-scan time. Stroke, 2016,47(3):695-700.
[18] Dowlatshahi D, Demchuk AM, Flaherty ML, et al. Defining hematoma expansion in intracerebral hemorrhage: Relationship with patient outcomes. Neurology, 2011,76(14):1238-1244.
[19] Dowlatshahi D, Smith EE, Flaherty ML, et al. Small intracerebral haemorrhages are associated with less haematoma expansion and better outcomes. Int J Stroke, 2011,6(3):201-206.
[20] Fujii Y, Takeuchi S, Harada A, et al. Hemostatic activation in spontaneous intracerebral hemorrhage. Stroke, 2001,32(4):883-890.
[21] Barras CD, Tress BM, Christensen S, et al. Density and shape as CT predictors of intracerebral hemorrhage growth. Stroke, 2009,40(4):1325-1331.
[22] Broderick JP, Diringer MN, Hill MD, et al. Determinants of intracerebral hemorrhage growth: An exploratory analysis. Stroke, 2007,38(3):1072-1075.
[23] Steiner T, Diringer MN, Schneider D, et al. Dynamics of intraventricular hemorrhage in patients with spontaneous intracerebral hemorrhage: Risk factors, clinical impact, and effect of hemostatic therapy with recombinant activated factor Ⅶ. Neurosurgery, 2006,59(4):767-773.
[24] Wada R, Aviv RI, Fox AJ, et al. CT angiography "spot sign" predicts hematoma expansion in acute intracerebral hemorrhage. Stroke, 2007,38(4):1257-1262.
[25] Koculym A, Huynh TJ, Jakubovic R, et al. CT perfusion spot sign improves sensitivity for prediction of outcome compared with CTA and postcontrast CT. AJNR Am J Neuroradiol, 2013,34(5):965-970.
[26] Rodriguez-Luna D, Coscojuela P, Rodriguez-Villatoro N, et al. Multiphase CT angiography improves prediction of intracerebral hemorrhage expansion. Radiology, 2017,285(3):932-940.
[27] Orito K, Hirohata M, Nakamura Y, et al. Leakage sign for primary intracerebral hemorrhage: A novel predictor of hematoma growth. Stroke, 2016,47(4):958-963.
[28] Li Q, Zhang G, Xiong X, et al. Black hole sign: Novel imaging marker that predicts hematoma growth in patients with intracerebral hemorrhage. Stroke, 2016,47(7):1777-1781.
[29] Schlunk F, Greenberg SM. The Pathophysiology of intracerebral hemorrhage formation and expansion. Transl Stroke Res, 2015,6(4):257-263.
[30] Li Q, Zhang G, Huang YJ, et al. Blend sign on computed tomography: Novel and reliable predictor for early hematoma growth in patients with intracerebral hemorrhage. Stroke, 2015,46(8):2119-2123.
[31] Li Q, Liu QJ, Yang WS, et al. Island sign: An imaging predictor for early hematoma expansion and poor outcome in patients with intracerebral hemorrhage. Stroke, 2017,48(11):3019-3025.
[2] Flaherty ML, Haverbusch M, Sekar P, et al. Long-term mortality after intracerebral hemorrhage. Neurology, 2006,66(8):1182-1186.
[3] Fujii Y, Tanaka R, Takeuchi S, et al. Hematoma enlargement in spontaneous intracerebral hemorrhage. J Neurosurg, 1994,80(1):51-57.
[4] Kazui S, Naritomi H, Yamamoto H, et al. Enlargement of spontaneous intracerebral hemorrhage. Incidence and time course. Stroke, 1996,27(10):1783-1787.
[5] Brott T, Broderick J, Kothari R, et al. Early hemorrhage growth in patients with intracerebral hemorrhage. Stroke, 1997,28(1):1-5.
[6] Wang X, Arima H, Al-Shahi Salman R, et al. Clinical prediction algorithm (BRAIN) to determine risk of hematoma growth in acute intracerebral hemorrhage. Stroke, 2015,46(2):376-381.
[7] Brouwers HB, Chang Y, Falcone GJ, et al. Predicting hematoma expansion after primary intracerebral hemorrhage. JAMA Neurol, 2014,71(2):158-164.
[8] Koga M, Yamagami H, Okuda S, et al. Blood glucose levels during the initial 72 h and 3-month functional outcomes in acute intracerebral hemorrhage: The SAMURAI-ICH study. J Neurol Sci, 2015,350(1-2):75-78.
[9] Feng W, Tauhid S, Goel S, et al. Hyperglycemia and outcome in intracerebral hemorrhage: From bedside to bench-more study is needed. Transl Stroke Res, 2012,3(Suppl 1):113-118.
[10] Godoy DA, Di Napoli M, Rabinstein AA. Treating hyperglycemia in neurocritical patients: Benefits and perils. Neurocrit Care, 2010,13(3):425-438.
[11] Sakamoto Y, Koga M, Yamagami H, et al. Systolic blood pressure after intravenous antihypertensive treatment and clinical outcomes in hyperacute intracerebral hemorrhage: The stroke acute management with urgent risk-factor assessment and improvement-intracerebral hemorrhage study. Stroke, 2013,44(7):1846-1851.
[12] Qureshi AI, Palesch YY, Martin R, et al. Effect of systolic blood pressure reduction on hematoma expansion, perihematomal edema, and 3-month outcome among patients with intracerebral hemorrhage: Results from the antihypertensive treatment of acute cerebral hemorrhage study. Arch Neurol, 2010,67(5):570-576.
[13] Qureshi AI, Palesch YY, Barsan WG, et al. Intensive blood-pressure lowering in patients with acute cerebral hemorrhage. N Engl J Med, 2016,375(11):1033-1043.
[14] Huynh TJ, Aviv RI, Dowlatshahi D, et al. Validation of the 9-point and 24-point hematoma expansion prediction scores and derivation of the PREDICT A/B scores. Stroke, 2015,46(11):3105-3110.
[15] Cucchiara B, Messe S, Sansing L, et al. Hematoma growth in oral anticoagulant related intracerebral hemorrhage. Stroke, 2008,39(11):2993-2996.
[16] Di Napoli M, Parry-Jones AR, Smith CJ, et al. C-reactive protein predicts hematoma growth in intracerebral hemorrhage. Stroke, 2014,45(1):59-65.
[17] Dowlatshahi D, Brouwers HB, Demchuk AM, et al. Predicting intracerebral hemorrhage growth with the spot sign: The effect of onset-to-scan time. Stroke, 2016,47(3):695-700.
[18] Dowlatshahi D, Demchuk AM, Flaherty ML, et al. Defining hematoma expansion in intracerebral hemorrhage: Relationship with patient outcomes. Neurology, 2011,76(14):1238-1244.
[19] Dowlatshahi D, Smith EE, Flaherty ML, et al. Small intracerebral haemorrhages are associated with less haematoma expansion and better outcomes. Int J Stroke, 2011,6(3):201-206.
[20] Fujii Y, Takeuchi S, Harada A, et al. Hemostatic activation in spontaneous intracerebral hemorrhage. Stroke, 2001,32(4):883-890.
[21] Barras CD, Tress BM, Christensen S, et al. Density and shape as CT predictors of intracerebral hemorrhage growth. Stroke, 2009,40(4):1325-1331.
[22] Broderick JP, Diringer MN, Hill MD, et al. Determinants of intracerebral hemorrhage growth: An exploratory analysis. Stroke, 2007,38(3):1072-1075.
[23] Steiner T, Diringer MN, Schneider D, et al. Dynamics of intraventricular hemorrhage in patients with spontaneous intracerebral hemorrhage: Risk factors, clinical impact, and effect of hemostatic therapy with recombinant activated factor Ⅶ. Neurosurgery, 2006,59(4):767-773.
[24] Wada R, Aviv RI, Fox AJ, et al. CT angiography "spot sign" predicts hematoma expansion in acute intracerebral hemorrhage. Stroke, 2007,38(4):1257-1262.
[25] Koculym A, Huynh TJ, Jakubovic R, et al. CT perfusion spot sign improves sensitivity for prediction of outcome compared with CTA and postcontrast CT. AJNR Am J Neuroradiol, 2013,34(5):965-970.
[26] Rodriguez-Luna D, Coscojuela P, Rodriguez-Villatoro N, et al. Multiphase CT angiography improves prediction of intracerebral hemorrhage expansion. Radiology, 2017,285(3):932-940.
[27] Orito K, Hirohata M, Nakamura Y, et al. Leakage sign for primary intracerebral hemorrhage: A novel predictor of hematoma growth. Stroke, 2016,47(4):958-963.
[28] Li Q, Zhang G, Xiong X, et al. Black hole sign: Novel imaging marker that predicts hematoma growth in patients with intracerebral hemorrhage. Stroke, 2016,47(7):1777-1781.
[29] Schlunk F, Greenberg SM. The Pathophysiology of intracerebral hemorrhage formation and expansion. Transl Stroke Res, 2015,6(4):257-263.
[30] Li Q, Zhang G, Huang YJ, et al. Blend sign on computed tomography: Novel and reliable predictor for early hematoma growth in patients with intracerebral hemorrhage. Stroke, 2015,46(8):2119-2123.
[31] Li Q, Liu QJ, Yang WS, et al. Island sign: An imaging predictor for early hematoma expansion and poor outcome in patients with intracerebral hemorrhage. Stroke, 2017,48(11):3019-3025.