Journal
NEUROLOGY
Volume 73, Issue 23, Pages 1963-1968Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0b013e3181c55ed3
Keywords
-
Categories
Funding
- National Health and Medical Research Council of Australia [358395]
- Health Research Council of New Zealand
- Ministry of Education, Culture, Sports, Science, and Technology of Japan
- University of Sydney
- Japan Heart Foundation
- OMRON Corporation
- Pfizer Inc.
- National Natural Science Foundation of China
- Shanghai Commissions of Science and Technology
- Shanghai Commission of Education
- European Union
- NIH [R01 NS38916, R01 NS62675]
- Les Laboratoires Servier
- National Health and Medical Research Council of Australia
- Boehringer Ingelheim
- Genzyme Corporation
Ask authors/readers for more resources
Background: Uncertainty surrounds the effects of cerebral edema on outcomes in intracerebral hemorrhage (ICH). Methods: We used data from the INTERACT trial to determine the predictors and prognostic significance of perihematomal edema over 72 hours after ICH. INTERACT included 404 patients with CT-confirmed ICH and elevated systolic blood pressure (BP) (150-220 mm Hg) who had the capacity to commence BP lowering treatment within 6 hours of ICH. Baseline and repeat CT (24 and 72 hours) were performed using standardized techniques, with digital images analyzed centrally. Predictors of growth in edema were determined using generalized estimating equations, and its effects on clinical outcomes were estimated using a logistic regression model. Results: Overall, 270 patients had 3 sequential CT scans available for analyses. At baseline, there was a highly significant correlation between hematoma and perihematomal edema volumes (r(2) = 0.45). Lower systolic BP and baseline hematoma volume were independently associated with absolute increase in perihematomal edema volume. History of hypertension, baseline hematoma volume, and earlier time from onset to CT were independently associated with relative increase in edema volume. Both absolute and relative increases in perihematomal edema growth were significantly associated with death or dependency at 90 days after adjustment for age, gender, and randomized treatment, but not when additionally adjusted for baseline hematoma volume. Conclusions: The degree of, and growth in, perihematomal edema are strongly related to the size of the underlying hematoma of acute intracerebral hemorrhage, and do not appear to have a major independent effect in determining the outcome from this condition. Neurology (R) 2009; 73: 1963-1968
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available