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Hypothermia Reduces Perihemorrhagic Edema After Intracerebral Hemorrhage

Stroke (1970), 2010-08, Vol.41 (8), p.1684-1689 [Peer Reviewed Journal]

2015 INIST-CNRS ;ISSN: 0039-2499 ;EISSN: 1524-4628 ;DOI: 10.1161/strokeaha.110.587758 ;PMID: 20616317 ;CODEN: SJCCA7

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Title:
Hypothermia Reduces Perihemorrhagic Edema After Intracerebral Hemorrhage
Author: KOLLMAR, Rainer ; STAYKOV, Dimitre ; DÖRFLER, Arnd ; SCHELLINGER, Peter D ; SCHWAB, Stefan ; BARDUTZKY, Jürgen
Subjects: Aged ; Aged, 80 and over ; Analysis of Variance ; Biological and medical sciences ; Brain - diagnostic imaging ; Brain - pathology ; Brain Edema - diagnostic imaging ; Brain Edema - etiology ; Brain Edema - pathology ; Brain Edema - prevention & control ; Brain Mapping ; Cerebral Hemorrhage - complications ; Cerebral Hemorrhage - diagnostic imaging ; Cerebral Hemorrhage - pathology ; Female ; Humans ; Hypothermia, Induced ; Image Processing, Computer-Assisted ; Male ; Medical sciences ; Middle Aged ; Neurology ; Neuropharmacology ; Neuroprotective agent ; Pharmacology. Drug treatments ; Pilot Projects ; Prospective Studies ; Radiography ; Respiration, Artificial ; Statistics, Nonparametric ; Treatment Outcome ; Vascular diseases and vascular malformations of the nervous system
Is Part Of: Stroke (1970), 2010-08, Vol.41 (8), p.1684-1689
Description: 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. 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. 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. Hypothermia prevented the increase of peri-hemorrhagic edema in patients with large sICH.
Publisher: Hagerstown, MD: Lippincott Williams & Wilkins
Language: English
Identifier: ISSN: 0039-2499
EISSN: 1524-4628
DOI: 10.1161/strokeaha.110.587758
PMID: 20616317
CODEN: SJCCA7
Source: MEDLINE
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Hypothermia Reduces Perihemorrhagic Edema After Intracerebral Hemorrhage

2015 INIST-CNRS ;ISSN: 0039-2499 ;EISSN: 1524-4628 ;DOI: 10.1161/strokeaha.110.587758 ;PMID: 20616317 ;CODEN: SJCCA7

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