Continued bleeding following acute intracerebral hemorrhage

摘要: In this Ph.D. thesis, ‘Continued bleeding following acute intracerebral hemorrhage’, we have discussed the background literature, risk factors, and underlying biology of hematoma expansion, as well clinical applicability CT angiography (CTA) 'spot sign' an imaging marker continued hemorrhage. first part thesis describe several studies examining occurrence, frequency outcome expansion (continued bleeding) We show that is common occurs in 40% all patients negatively impacts functional outcome. Furthermore, it shown preventable if diagnosed a timely fashion. second further examined Two genetic Apolipoprotein E e2 allele associated with both bleeding, termed ‘CT spot sign’. These findings confirm ‘avalanche model’ cascading small vessel injury mechanism for expansion. This also includes two sign its role order types brain hemorrhages. het third final aimed at personalized treatment The main results include development prediction model to accurately assess which are highest based on few important factors: size hematoma, time onset, coagulation status neuroimaging findings. With easily obtainable information can stratify medical surgical treatments, currently tested ongoing trial described section thesis. By selecting high-risk population using models, selected theoretically much more likely benefit. Moreover, low would turn not be needlessly exposed potential harms medications or invasive procedures. approach, tantalizing opportunity create individualized patient-based scheme treat our hemorrhage patients. pivotal importance, since there pressing need options, no proven therapies available. conclusion, included primary hemorrhage; 1.) Hematoma preventable; 2.) Genetic, clinical, predictors (termed CTA sign) been identified help comprehend expansion; 3.) Selection feasible. contribute better understanding could result design spontaneous