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Intracerebral Hemorrhage: Advances in Preclinical Approaches, Diagnoses and Treatment
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Intracerebral Hemorrhage: Advances in Preclinical Approaches, Diagnoses and Treatment

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (20 November 2022) | Viewed by 7240

Special Issue Editors

Dr. Evgenii Belykh

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Guest Editor
Department of Neurosurgery, New Jersey Medical School, Rutgers University, Newark, NJ, USA
Interests: fluorescence and optical imaging in neurosurgery; neurooncology; skull base surgery; quantitative neuroanatomy; simulation technologies; microneurosurgery training
Dr. Samuel X. Shi

E-Mail Website
Guest Editor
Clinical Neuroscience Research Centre, Department of Neurosurgery, Tulane University, New Orleans, LA 70012, USA
Interests: stroke; intracerebral hemorrhage; immunology; neuroinflammation; innate immunity; T cells; acute ischemic stroke
Dr. Kaibin Shi

E-Mail Website
Guest Editor
1. China National Clinical Research Center for Neurological Diseases, Jing-Jin Center for Neuroinflammation, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
2. Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
Interests: stroke treatment and management

Special Issue Information

Each year, intracerebral hemorrhage (ICH) occupies >10% of the approximate 17 million strokes globally, this stroke subtype having a mortality rate of over 40% and leaving lasting disabilities in the majority of surviving patients; thus, representing a significant public health challenge. Despite intense investigations targeting modifiable factors with hemostatic agents and iron chelators to improve outcomes, no large Phase III therapeutic or surgical ICH trial has been positive by the primary end point, the latest trials emphasizing the maximization of clot removal and minimizing brain injury from the surgical approach. Therapeutic developments aim to limit secondary injury by modulating the acute immune response to hemorrhagic strokes by limiting harmful processes and leveraging endogenous protective pathways; therefore, the future of ICH therapy must focus on the delivery of medical and surgical therapies as soon as possible if we are to improve outcomes. This Special Issue “Intracerebral Hemorrhage: Advances in Preclinical Approaches, Diagnoses and Treatment” aims to curate the latest advances in preclinical studies and management approaches regarding this disease, welcoming the submission of review articles as well as original research papers dealing with the topics in the management, diagnoses, and therapy of ICH.

Dr. Evgenii Belykh
Dr. Samuel X. Shi
Dr. Kaibin Shi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • intracerebral hemorrhage
  • hemorrhagic stroke
  • stroke
  • neuroprotection
  • neurosurgery
  • neuroinflammation

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Published Papers (4 papers)

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Research

15 pages, 1835 KiB  
Article
Roles of Bilirubin in Hemorrhagic Transformation of Different Types and Severity
by Jiahao Chen, Yiting Chen, Yisi Lin, Jingfang Long, Yufeng Chen, Jincai He and Guiqian Huang
J. Clin. Med. 2023, 12(4), 1471; https://doi.org/10.3390/jcm12041471 - 12 Feb 2023
Viewed by 1467
Abstract
Background: Hemorrhagic transformation (HT) is a severe complication in patients with acute ischemic stroke (AIS). This study was performed to explore and validate the relation between bilirubin levels and spontaneous HT (sHT) and HT after mechanical thrombectomy (tHT). Methods: The study population consisted [...] Read more.
Background: Hemorrhagic transformation (HT) is a severe complication in patients with acute ischemic stroke (AIS). This study was performed to explore and validate the relation between bilirubin levels and spontaneous HT (sHT) and HT after mechanical thrombectomy (tHT). Methods: The study population consisted of 408 consecutive AIS patients with HT and age- and sex-matched patients without HT. All patients were divided into quartiles according to total bilirubin (TBIL) level. HT was classified as hemorrhagic infarction (HI) and parenchymal hematoma (PH) based on radiographic data. Results: In this study, the baseline TBIL levels were significantly higher in the HT than non-HT patients in both cohorts (p < 0.001). Furthermore, the severity of HT increased with increasing TBIL levels (p < 0.001) in sHT and tHT cohorts. The highest quartile of TBIL was associated with HT in sHT and tHT cohorts (sHT cohort: OR = 3.924 (2.051–7.505), p < 0.001; tHT cohort: OR = 3.557 (1.662–7.611), p = 0.006). Conclusions: Our results suggest that an increased TBIL is associated with a high risk of patients with sHT and tHT, and that TBIL is more suitable as a predictor for sHT than tHT. These findings may help to identify patients susceptible to different types and severity of HT. Full article
(This article belongs to the Special Issue Intracerebral Hemorrhage: Advances in Preclinical Approaches, Diagnoses and Treatment)
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9 pages, 746 KiB  
Article
Predictors of Symptomatic Intracranial Hemorrhage after Endovascular Thrombectomy in Acute Ischemic Stroke Patients with Anterior Large Vessel Occlusion—Procedure Time and Reperfusion Quality Determine
by Yan Li, Natalie van Landeghem, Aydin Demircioglu, Martin Köhrmann, Philipp Dammann, Marvin Darkwah Oppong, Ramazan Jabbarli, Jens Matthias Theysohn, Jens-Christian Altenbernd, Hanna Styczen, Michael Forsting, Isabel Wanke, Benedikt Frank and Cornelius Deuschl
J. Clin. Med. 2022, 11(24), 7433; https://doi.org/10.3390/jcm11247433 - 15 Dec 2022
Cited by 4 | Viewed by 2049
Abstract
Purpose: We aimed to evaluate predictors of symptomatic intracranial hemorrhage (sICH) in acute ischemic stroke (AIS) patients following thrombectomy due to anterior large vessel occlusion (LVO). Methods: Data on stroke patients from January 2018 to December 2020 in a tertiary care centre were [...] Read more.
Purpose: We aimed to evaluate predictors of symptomatic intracranial hemorrhage (sICH) in acute ischemic stroke (AIS) patients following thrombectomy due to anterior large vessel occlusion (LVO). Methods: Data on stroke patients from January 2018 to December 2020 in a tertiary care centre were retrospectively analysed. sICH was defined as intracranial hemorrhage associated with a deterioration of at least four points in the National Institutes of Health Stroke Scale (NIHSS) score or hemorrhage leading to death. A smoothed ridge regression model was run to analyse the impact of 15 variables on their association with sICH. Results: Of the 174 patients (median age 77, 41.4% male), sICH was present in 18 patients. Short procedure time from groin puncture to reperfusion (per 10 min OR 1.24; 95% CI 1.071–1.435; p = 0.004) and complete reperfusion (TICI 3) (OR 0.035; 95% CI 0.003–0.378; p = 0.005) were significantly associated with a lower risk of sICH. On the contrary, successful reperfusion (TICI 3 and TICI 2b) was not associated with a lower risk of sICH (OR 0.508; 95% CI 0.131–1.975, p = 0.325). Neither the total time from symptom onset to reperfusion nor the intravenous thrombolysis was a predictor of sICH (per 10 min OR 1.0; 95% CI 0.998–1.001, p = 0.745) (OR 1.305; 95% CI 0.338–5.041, p = 0.697). Conclusion: Our findings addressed the paramount importance of short procedure time and complete reperfusion to minimize sICH risk. The total ischemic time from onset to reperfusion was not a predictor of sICH. Full article
(This article belongs to the Special Issue Intracerebral Hemorrhage: Advances in Preclinical Approaches, Diagnoses and Treatment)
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12 pages, 3680 KiB  
Article
Subarachnoid Haemorrhage—Incidence of Hospitalization, Management and Case Fatality Rate—In the Silesian Province, Poland, in the Years 2009–2019
by Beata Łabuz-Roszak, Michał Skrzypek, Anna Starostka-Tatar, Anetta Lasek-Bal, Mariusz Gąsior and Marek Gierlotka
J. Clin. Med. 2022, 11(14), 4242; https://doi.org/10.3390/jcm11144242 - 21 Jul 2022
Cited by 1 | Viewed by 1451
Abstract
Little is known about the epidemiology of subarachnoid haemorrhage (SAH) in Poland, and until now no such research has been conducted for Silesia, which is the second largest province with circa 4.5 million inhabitants. Therefore, the current study was done to assess the [...] Read more.
Little is known about the epidemiology of subarachnoid haemorrhage (SAH) in Poland, and until now no such research has been conducted for Silesia, which is the second largest province with circa 4.5 million inhabitants. Therefore, the current study was done to assess the data on SAH in the Silesian Province, Poland. The study was based on the data obtained from the administrative databases of the only public health insurer in Poland (the National Health Fund, NHF) from 2009 to 2019. The SAH cases were selected based on primary diagnosis coded in ICD-10 as I60. The total number of SAH cases was 2014 (41.8% men, 58.2% women). The number of SAH hospitalizations decreased from 199 in 2009 to 166 cases in 2019; p < 0.05. The median age increased from 58 in 2009 to 62 years in 2019; p < 0.001. Endovascular treatment or clipping of the aneurysm was performed in 866 cases (43%). An increase in in-hospital mortality was observed from 31% in 2009 to 38% in 2019 (p = 0.013). Despite the number of stroke units increasing, in-hospital mortality in SAH patients is high, and the number of vascular interventions seems insufficient. Better organization for care of SAH patients is needed in Poland. Full article
(This article belongs to the Special Issue Intracerebral Hemorrhage: Advances in Preclinical Approaches, Diagnoses and Treatment)
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11 pages, 275 KiB  
Article
Fibrinogen to Albumin Ratio as Early Serum Biomarker for Prediction of Intra-Hospital Mortality in Neurosurgical Intensive Care Unit Patients with Spontaneous Intracerebral Hemorrhage
by Michael Bender, Kristin Haferkorn, Shahin Tajmiri-Gondai, Eberhard Uhl and Marco Stein
J. Clin. Med. 2022, 11(14), 4214; https://doi.org/10.3390/jcm11144214 - 20 Jul 2022
Cited by 11 | Viewed by 1648
Abstract
Background: The prognostic value of the fibrinogen to albumin ratio on intrahospital mortality has been investigated in patients with cardiovascular disease, cancer, sepsis, and ischemic stroke; however, it has not been investigated for neurosurgical patients with spontaneous intracerebral hemorrhage (ICH). The present study [...] Read more.
Background: The prognostic value of the fibrinogen to albumin ratio on intrahospital mortality has been investigated in patients with cardiovascular disease, cancer, sepsis, and ischemic stroke; however, it has not been investigated for neurosurgical patients with spontaneous intracerebral hemorrhage (ICH). The present study investigates the impact of the fibrinogen to albumin ratio upon admission for intrahospital mortality in neurosurgical intensive care unit (ICU) patients with spontaneous ICH. Methods: A total of 198 patients with diagnosis of spontaneous ICH treated from 10/2008 to 12/2017 at our ICU were retrospectively analyzed. Blood samples were drawn upon admission, and the patients’ demographic, medical data, and cranial imaging were collected. Binary logistic regression analysis was performed to identify independent prognostic factors for intrahospital mortality. Results: The total rate of intrahospital mortality was 35.4% (n = 70). In the multivariate regression analysis, higher fibrinogen to albumin ratio (OR = 1.16, CI = 1.02–1.31, p = 0.03) upon admission was an independent predictor of intrahospital mortality in neurosurgical ICU patients with ICH. Moreover, a fibrinogen to albumin ratio cut-off level of >0.075 was related to increased intrahospital mortality (Youden’s index = 0.26, sensitivity = 0.51, specificity = 0.77). Conclusion: A fibrinogen to albumin ratio > 0.075 was significantly associated with increased intrahospital mortality in ICH patients. Full article
(This article belongs to the Special Issue Intracerebral Hemorrhage: Advances in Preclinical Approaches, Diagnoses and Treatment)
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