关键词: 脑出血; 脑水肿; 预测因子; 预后

Abstract:

【Abstract】 Objective To evaluate the nature history of perihematomal edema (PHE) in intracerebral hemorrhage (ICH) patients using X-ray computed tomography (CT), to analyze the predictive factors of the severity of initial and peak PHE, and to explore the relationship between PHE and clinical outcome. Methods It was a retrospective study of consecutive patients with ICH admitted to Beijing Tiantan Hospital from October 2009 to November 2011. Medical records, laboratory data, and CT scan were performed at admission. On (12±2) days after ICH, CT angiography and venography were given to analyze peak edema and cerebral vascular system. Neurologic assessments were performed at admission, patient discharge and 3 months after ICH. Results Among 51 patients enrolled, there were 36 cases of basal ganglia hemorrhage, 7 cases of thalamus hemorrhage and 8 cases of lobar hemorrhage. According to our study, baseline hematoma volume was the only correlation factor of baseline edema volume (r=0.799, P＜0.001) and antiplatelet use on admission is associated with more severe relative baseline edema (r=-2.456, P=0.014). Peak edema volume had a positive correlation with both baseline edema (r=0.720, P＜0.001) and hematoma volume and peak hematoma volume (r=0.788, P＜0.001). Peak edema index is only related with baseline edema index (r=0.357, P=0.010). This study revealed significant relationship between the baseline/peak edema volume and acute clinical deterioration/modified Rankin Scale (mRS) and National Institutes of Health Stroke Scale (NIHSS) on discharge and 90 days of onset, but failed to find correlations between baseline/peak edema index and clinical outcomes. Conclusion Antiplatelet use on admission is associated with more severe relative baseline edema. Acute clinical deterioration and long-term functional outcome after ICH are only correlated to initial absolute PHE severity.

Key words: Intracerebral hemorrhage; Brain edema; Predictive factors; Clinical outcome