Document Detail


Hypothermia reduces perihemorrhagic edema after intracerebral hemorrhage.
MedLine Citation:
PMID:  20616317     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The prognosis of spontaneous intracerebral hemorrhage (sICH) is poor because of the mass effect arising from the hematoma and the associated peri-hemorrhagic edema, leading to increased intracranial pressure. Because the efficacy of surgical and anti-edematous treatment strategies is limited, we investigated the effects of mild induced hypothermia in patients with large sICH. METHODS: Twelve patients with supratentorial sICH >25 mL were treated by hypothermia of 35 degrees C for 10 days. Evolution of hematoma volume and perifocal edema was measured by cranial CT. Functional outcome was assessed after 90 days. These patients were compared to patients (n=25; inclusion criteria: sICH volume >25 mL, no acute restriction of medical therapy on admission) from the local hemorrhage data bank (n=312). Side effects of hypothermia were analyzed. RESULTS: All patients from both groups needed mechanical ventilation and were treated in a neurocritical care unit. All hypothermic patients (mean age, 60+/-10 years) survived until day 90, whereas 7 patients died in the control group (mean age, 67+/-7 years). Absolute hematoma size on admission was 58+/-29 mL (hypothermia) compared to 57+/-31 mL (control). In the hypothermia group, edema volume remained stable during 14 days (day 1, 53+/-43 mL; day 14, 57+/-45 mL), whereas edema significantly increased in the control group from 40+/-28 mL (day 1) to 88+/-47 mL (day 14). ICH continuously dissolved in both groups. Pneumonia rate was 100% in the hypothermia group and 76% in controls (P=0.08). No significant side effects of hypothermia were observed. CONCLUSIONS: Hypothermia prevented the increase of peri-hemorrhagic edema in patients with large sICH.
Authors:
Rainer Kollmar; Dimitre Staykov; Arnd Dörfler; Peter D Schellinger; Stefan Schwab; Jürgen Bardutzky
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Publication Detail:
Type:  Journal Article     Date:  2010-07-08
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  41     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-27     Completed Date:  2010-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1684-9     Citation Subset:  IM    
Affiliation:
Neurology Department, University of Erlangen, Erlangen, Germany. rainer.kollmar@uk-erlangen.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Analysis of Variance
Brain / pathology*,  radiography
Brain Edema / etiology,  pathology,  prevention & control*,  radiography
Brain Mapping
Cerebral Hemorrhage / complications*,  pathology,  radiography
Female
Humans
Hypothermia, Induced*
Image Processing, Computer-Assisted
Male
Middle Aged
Pilot Projects
Prospective Studies
Respiration, Artificial
Statistics, Nonparametric
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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