Integral neuroimaging criteria for predicting the outcome of the acute period of spontaneous supratentorial intracerebral hemorrhage on the background of conservative therapy

Authors

DOI:

https://doi.org/10.14739/2310-1210.2022.5.260450

Keywords:

cerebral hemorrhage, neuroimaging, prognosis

Abstract

The aim of the study was to develop criteria for predicting the outcome of the acute period of spontaneous supratentorial intracerebral hemorrhage (SSICH) on the background of conservative therapy, taking into consideration the lesion localization in conjunction with neuroimaging parameters of the quantitative severity assessment of the damage to cerebral structures.

Materials and methods. Prospective cohort examination of 314 patients in acute period of SSICH on the ground of conservative treatment. Clinical and neurological examination consisted of using the Full Outline of Unresponsiveness coma scale and NIHHS, neuroimaging with the help of computed tomography with detection of SSICH localization, volume of intracranial hemorrhage, secondary intraventricular hemorrhage and midline shift. Disease acute period outcome was evaluated on the 21st day by the Rankin scale.

Results. It was detected that integrated neuroimaging SSICH’s type considering its localization and quantitative severity estimation of cerebral structure injury was closely associated with the disease acute period outcome on the ground of conservative therapy (χ2 Pearson = 308.6, Р < 0.0001). Thus, mortality rate was the highest in patients with posteromedial type of thalamic hemorrhage (50.0 %), global type of thalamic hemorrhage (91.7 %) and massive type of striatocapsular hemorrhage (89.8 %). Unfavorable functional outcome as the modified Rankin scale score 4–5 on 21st disease day predominated among patients with posterolateral types of thalamic hemorrhage (76.5 %) and striacapsular hemorrhage (64.3 %). Whereas the frequency of favorable outcome was the highest among patients with anterior/dorsal type of thalamic hemorrhage (100.0 %), posteromedial (88.0 %), middle (95.0 %), lateral types of striatocapsular hemorrhage (61.9 %) and lobar (74.5 %) hemorrhage.

Conclusions. Posteromedial type of thalamic hemorrhage, global type of thalamic hemorrhage and massive type of striatocapsular hemorrhage are the predictors of lethal outcome of the acute period of SSIСH on the background of conservative therapy. Criteria for unfavorable short-term functional outcome are posterolateral types of thalamic and striatocapsular hemorrhage, while anterior/dorsal type of thalamic hemorrhage, posteromedial/middle type of striatocapsular hemorrhage and lobar hemorrhage are associated with favorable outcome of the acute period of the disease.

Author Biographies

O. А. Kozolkin, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of Nervous Diseases

A. A. Kuznietsov, Zaporizhzhia State Medical University, Ukraine

MD, PhD, Associate Professor of the Department of Nervous Diseases

References

Morotti, A., & Goldstein, J. N. (2016). Diagnosis and Management of Acute Intracerebral Hemorrhage. Emergency medicine clinics of North America, 34(4), 883-899. https://doi.org/10.1016/j.emc.2016.06.010

Schrag, M., & Kirshner, H. (2020). Management of Intracerebral Hemorrhage: JACC Focus Seminar. Journal of the American College of Cardiology, 75(15), 1819-1831. https://doi.org/10.1016/j.jacc.2019.10.066

Dastur, C. K., & Yu, W. (2017). Current management of spontaneous intracerebral haemorrhage. Stroke and vascular neurology, 2(1), 21-29. https://doi.org/10.1136/svn-2016-000047

Hostettler, I. C., Seiffge, D. J., & Werring, D. J. (2019). Intracerebral hemorrhage: an update on diagnosis and treatment. Expert review of neurotherapeutics, 19(7), 679-694. https://doi.org/10.1080/14737175.2019.1623671

Veltkamp, R., & Purrucker, J. (2017). Management of Spontaneous Intracerebral Hemorrhage. Current neurology and neuroscience reports, 17(10), 80. https://doi.org/10.1007/s11910-017-0783-5

Weimar, C., & Kleine-Borgmann, J. (2017). Epidemiology, Prognosis and Prevention of Non-Traumatic Intracerebral Hemorrhage. Current pharmaceutical design, 23(15), 2193-2196. https://doi.org/10.2174/1381612822666161027152234

Thabet, A. M., Kottapally, M., & Hemphill, J. C., 3rd (2017). Management of intracerebral hemorrhage. Handbook of clinical neurology, 140, 177-194. https://doi.org/10.1016/B978-0-444-63600-3.00011-8

Williamson, C., Morgan, L., & Klein, J. P. (2017). Imaging in Neurocritical Care Practice. Seminars in respiratory and critical care medicine, 38(6), 840-852. https://doi.org/10.1055/s-0037-1608770

You, S., Zheng, D., Delcourt, C., Sato, S., Cao, Y., Zhang, S., Yang, J., Wang, X., Lindley, R. I., Robinson, T., Anderson, C. S., & Chalmers, J. (2019). Determinants of Early Versus Delayed Neurological Deterioration in Intracerebral Hemorrhage. Stroke, 50(6), 1409-1414. https://doi.org/10.1161/STROKEAHA.118.024403

Specogna, A. V., Turin, T. C., Patten, S. B., & Hill, M. D. (2014). Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis. PloS one, 9(5), e96743. https://doi.org/10.1371/journal.pone.0096743

Kuznietsov, A. A. (2018). Comparative analysis of predictive significance of neuroimaging parameters in patients with spontaneous supratentorial intracerebral hemorrhage. Zaporozhye Medical Journal, 20(4), 543-547. http://zmj.zsmu.edu.ua/article/view/137097

Neisewander, B. L., Hu, K., Tan, Z., Zakrzewski, J., Kheirkhah, P., Kumar, P., Shah, M., Cotanche, D., Shah, K., Esfahani, D. R., & Mehta, A. I. (2018). Location of Thalamic Hemorrhage Impacts Prognosis. World neurosurgery, 116, e525-e533. https://doi.org/10.1016/j.wneu.2018.05.026

Ruiz-Sandoval, J. L., Chiquete, E., Parra-Romero, G., Carrillo-Loza, K., Parada-Garza, J. D., Pérez-Gómez, H. R., Ochoa-Plascencia, M. R., & Aguirre-Portillo, L. (2019). Hypertensive thalamic hemorrhage: analysis of short-term outcome. The International journal of neuroscience, 129(2), 189-194. https://doi.org/10.1080/00207454.2018.1518905

Sreekrishnan, A., Dearborn, J. L., Greer, D. M., Shi, F. D., Hwang, D. Y., Leasure, A. C., Zhou, S. E., Gilmore, E. J., Matouk, C. C., Petersen, N. H., Sansing, L. H., & Sheth, K. N. (2016). Intracerebral Hemorrhage Location and Functional Outcomes of Patients: A Systematic Literature Review and Meta-Analysis. Neurocritical care, 25(3), 384-391. https://doi.org/10.1007/s12028-016-0276-4

Delcourt, C., Sato, S., Zhang, S., Sandset, E. C., Zheng, D., Chen, X., Hackett, M. L., Arima, H., Hata, J., Heeley, E., Al-Shahi Salman, R., Robinson, T., Davies, L., Lavados, P. M., Lindley, R. I., Stapf, C., Chalmers, J., Anderson, C. S., & INTERACT2 Investigators (2017). Intracerebral hemorrhage location and outcome among INTERACT2 participants. Neurology, 88(15), 1408-1414. https://doi.org/10.1212/WNL.0000000000003771

Chung, C. S., Caplan, L. R., Han, W., Pessin, M. S., Lee, K. H., & Kim, J. M. (1996). Thalamic haemorrhage. Brain, 119(Pt 6), 1873-1886. https://doi.org/10.1093/brain/119.6.1873

Chung, C. S., Caplan, L. R., Yamamoto, Y., Chang, H. M., Lee, S. J., Song, H. J., Lee, H. S., Shin, H. K., & Yoo, K. M. (2000). Striatocapsular haemorrhage. Brain, 123(Pt 9), 1850-1862. https://doi.org/10.1093/brain/123.9.1850

Ministry of Health of Ukraine. (2014, April 17). Pro zatverdzhennia ta vprovadzhennia medyko-tekhnolohichnykh dokumentiv zi standartyzatsii medychnoi dopomohy pry hemorahichnomu insulti [On Approval and Introduction of Medical and Technological Documents for Stan-dardization of Care in Ischemic Stroke (No. 275)]. https://zakon.rada.gov.ua/rada/show/v0275282-14#Text

Kozyolkin, О. А., & Kuznietsov А. А. (2020). Prohnostychne znachennia intehralnoi otsinky tiazhkosti urazhennia tserebralnykh struktur u patsiientiv u hostromu periodi spontannoho supratentorialnoho vnutrishnomozkovoho krovovylyvu [Prognostic value of integrated brain structures affection assessment in patients in acute period of spontaneous supratentorial intracerebral hemorrhage]. Zdobutky klinichnoi i eksperymentalnoi medytsyny, (4), 95-106. [in Ukrainian]. https://doi.org/10.11603/1811-2471.2020.v.i4.11760

Panchal, H. N., Shah, M. S., & Shah, D. S. (2015). Intracerebral Hemorrhage Score and Volume as an Independent Predictor of Mortality in Primary Intracerebral Hemorrhage Patients. The Indian journal of surgery, 77(Suppl 2), 302-304. https://doi.org/10.1007/s12262-012-0803-2

Safatli, D. A., Günther, A., Schlattmann, P., Schwarz, F., Kalff, R., & Ewald, C. (2016). Predictors of 30-day mortality in patients with spontaneous primary intracerebral hemorrhage. Surgical neurology international, 7(Suppl 18), S510-S517. https://doi.org/10.4103/2152-7806.187493

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Published

2022-11-09

How to Cite

1.
Kozolkin OА, Kuznietsov AA. Integral neuroimaging criteria for predicting the outcome of the acute period of spontaneous supratentorial intracerebral hemorrhage on the background of conservative therapy. Zaporozhye Medical Journal [Internet]. 2022Nov.9 [cited 2024Nov.25];24(5):521-8. Available from: http://zmj.zsmu.edu.ua/article/view/260450

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Original research