|Table of Contents|

Correlation between early neurological deterioration and poor functional outcomes in patients with acute intracerebral hemorrhage



Research Field:
Publishing date:



Correlation between early neurological deterioration and poor functional outcomes in patients with acute intracerebral hemorrhage


WANG Xingchen YANG Wensong LI Rui LI Qi XIE Peng

Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China


intracerebral hemorrhage neurological deterioration prognosis


ObjectiveTo study the correlation between early neurological deterioration (END) and poor functional outcomes in patients with acute intracerebral hemorrhage. MethodsEightytwo patients with acute cerebral hemorrhage were admitted in our department between January, 2016 and March, 2017, including 16 with positive findings of END and 66 with negative findings of END. The clinical data and 90day functional outcomes were compared between the 2 groups, and univariate and multivariate logistic regression analyses were used to assess the correlation between END and poor functional outcomes of the patients. Results The patients with END had a significantly higher incidence of poor functional outcome than the ENDnegative patients [87.5%(14/16) vs 18.2% (12/66), P<0.05]. Multivariate logistic regression analysis showed that both END (OR=25.57,95%CI:1.53~427.39,P=0.024)and random blood glucose level (OR=2.11, 95%CI:1.13~3.91,P=0.018)were independent risk factors of poor functional outcome in patients with acute intracerebral hemorrhage. ConclusionEND is associated with poor functional outcomes in patients with acute intracerebral hemorrhage.


[1]FALCONE G J, BIFFI A, BROUWERS H B, et al. Predictors of hematoma volume in deep and lobar supratentorial intracerebral hemorrhage[J]. JAMA Neurol, 2013, 70(8): 988-994. DOI:10.1001/jamaneurol.2013.98.
[2]KWON H M, LEE Y S, BAE H J, et al. Homocysteine as a predictor of early neurological deterioration in acute ischemic stroke[J]. Stroke, 2014, 45(3): 871-873. DOI:10.1161/STROKEAHA.113.004099.
[3]马国胜, 彭彩丽, 张东, 等. 急性重症脑血管病死亡风险的多因素分析及预测[J]. 中华老年心脑血管病杂志, 2013, 15(5): 540-541.
MA G S, PENG C L, ZHANG D, et al. Multivariate analysis and prediction of death risk in severe acute cerebrovascular disease [J]. Chin J Geriatr Heart Brain Ves Dis, 2013, 15(5): 540-541.
[4]ARENILLAS J F, ROVIRA A, MOLINA C A, et al. Prediction of early neurological deterioration using diffusion and perfusionweighted imaging in hyperacute middle cerebral artery ischemic stroke[J]. Stroke, 2002, 33(9): 2197-2203. DOI: 10.1161/01.str.0000027861.75884.df.
[5]SAQQUR M, MOLINA C A, SALAM A, et al. Clinical deterioration after intravenous recombinant tissue plasminogen activator treatment: a multicenter transcranial doppler study[J]. Stroke, 2007(1): 69-74. DOI: 10.1161/01.str.0000251800.01964.f6.
[6]OIS A, MARTINEZRODRIGUEZ J E, MUNTEIS E, et al. Stenoocclusive arterial disease and early neurological deterioration in acute ischemic stroke[J]. Cerebrovasc Dis, 2008, 25(1-2): 151-156. DOI: 10.1159/000113732.
[7]FISHER M, BOGOUSSLAVSKY J. Current review of cerebrovascular disease[M]. Philadelphia: Current Medicine Group, 2001.
[8]D VALOS A, CASTILLO J. Progressing stroke. In: Fisher M, Bogousslavsky J eds. Current review of cerebrovascular disease[J]. Philadelphia: Current Medicine, 1999: 149-160.
[9]SORIMACHI T, FUJII Y. Early neurological change in patients with spontaneous supratentorial intracerebral hemorrhage[J]. J Clin Neurosci, 2010, 17(11): 1367-1371. DOI: 10.1016/j.jocn.2010.02.024.
[10]DU Q, YANG D B, SHEN Y F, et al. Plasma leptin level predicts hematoma growth and early neurological deterioration after acute intracerebral hemorrhage[J]. Peptides, 2013, 45: 35-39. DOI: 10.1016/j.peptides.2013.04.017.
[11]LEIRA R, D VALOS A, SILVA Y, et al. Early neurologic deterioration in intracerebral hemorrhage: predictors and associated factors[J]. Neurology, 2004, 63(3): 461-467. DOI: 10.1212/01.wnl.0000133204.81153.ac.
[12]RINCON F, LYDEN P, MAYER S A. Relationship between temperature, hematoma growth, and functional outcome after intracerebral hemorrhage[J]. Neurocrit Care, 2013, 18(1): 45-53. DOI: 10.1007/s1202801297799.
[13]DOWLATSHAHI D, DEMCHUK A M, FLAHERTY M L, et al. Defining hematoma expansion in intracerebral hemorrhage: relationship with patient outcomes[J]. Neurology, 2011, 76(14): 1238-1244. DOI: 10.1212/WNL.0b013e3182143317.
[14]YAN T, CHOPP M, CHEN J. Experimental animal models and inflammatory cellular changes in cerebral ischemic and hemorrhagic stroke[J]. Neurosci Bull, 2015, 31(6): 717-734. DOI: 10.1007/s122640151567z.
[15]ANTUNES A P, SCHIEFECKER A J, BEER R, et al. Higher brain extracellular potassium is associated with brain metabolic distress and poor outcome after aneurysmal subarachnoid hemorrhage[J]. Crit Care, 2014, 18(3): R119. DOI: 10.1186/cc13916.
[16]胡登科, 刘利生, 刘晓海, 等. 老年急性丘脑出血患者血糖水平与预后的临床分析[J]. 中华老年心脑血管病杂志, 2013, 15(12): 1305-1306.
HU D K, LIU L S, LIU X H, et al. Effect of blood glucose level on prognosis of elderly acute thalamic hemorrhage patients [J]. Chin J Geriatr Heart Brain Ves Dis, 2013, 15(12): 1305-1306.
[17]STRAHLE J, GARTON HJ, MAHER CO, et al. Mechanisms of hydrocephalus after neonatal and adult intraventricular hemorrhage[J]. Transl Stroke Res, 2012, 3(Suppl 1): 25-38. DOI: 10.1007/s1297501201829.
[18]ZINKSTOK S M, BEENEN L F, MAJOIE C B, et al. Early deterioration after thrombolysis plus aspirin in acute stroke: a post hoc analysis of the antiplatelet therapy in combination with recombinant tPA thrombolysis in ischemic stroke trial[J]. Stroke, 2014, 45(10): 3080-3082. DOI: 10.1161/STROKEAHA.114.006268.
[19]MANNING L, HIRAKAWA Y, ARIMA H, et al. Blood pressure variability and outcome after acute intracerebral haemorrhage: a posthoc analysis of INTERACT2, a randomised controlled trial[J]. Lancet Neurol, 2014, 13(4): 364-373. DOI: 10.1016/S14744422(14)700183.


Last Update: 2018-07-03