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Progressing haemorrhagic stroke: categories, causes, mechanisms and managements.

Chen S, Zeng L, Hu Z - J. Neurol. (2014)

Bottom Line: Haematoma expansion, intraventricular haemorrhage, perihaematomal oedema, and inflammation, can all cause an acute progression of haemorrhagic stroke.Specific 'second peak' of perihaematomal oedema after intracerebral haemorrhage and 'tension haematoma' are the primary causes of subacute progression.For the chronic progressing haemorrhagic stroke, the occult vascular malformations, trauma, or radiologic brain surgeries can all cause a slowly expanding encapsulated haematoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Xiangya Second Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China.

ABSTRACT
Haemorrhagic stroke is a severe stroke subtype with high rates of morbidity and mortality. Although this condition has been recognised for a long time, the progressing haemorrhagic stroke has not received adequate attention, and it accounts for an even worse clinical outcome than the nonprogressing types of haemorrhagic stroke. In this review article, we categorised the progressing haemorrhagic stroke into acute progressing haemorrhagic stroke, subacute haemorrhagic stroke, and chronic progressing haemorrhagic stroke. Haematoma expansion, intraventricular haemorrhage, perihaematomal oedema, and inflammation, can all cause an acute progression of haemorrhagic stroke. Specific 'second peak' of perihaematomal oedema after intracerebral haemorrhage and 'tension haematoma' are the primary causes of subacute progression. For the chronic progressing haemorrhagic stroke, the occult vascular malformations, trauma, or radiologic brain surgeries can all cause a slowly expanding encapsulated haematoma. The mechanisms to each type of progressing haemorrhagic stroke is different, and the management of these three subtypes differs according to their causes and mechanisms. Conservative treatments are primarily considered in the acute progressing haemorrhagic stroke, whereas surgery is considered in the remaining two types.

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Related in: MedlinePlus

Mechanisms of CEICH
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Fig6: Mechanisms of CEICH

Mentions: As for the radiosurgery, repetitive minor bleeding within the radionecrotic brain tissue most likely may initiate the formation of CEICH [49, 92, 96]. Nakamizo et al. [127] believes that radiosurgery could impose hypoxic stress on the surrounding brain tissue and induce a transcription of vascular endothelial growth factor, which could contribute to the abnormal angiogenesis and vascular leakage that expand the haematoma (Fig. 6).Fig. 6


Progressing haemorrhagic stroke: categories, causes, mechanisms and managements.

Chen S, Zeng L, Hu Z - J. Neurol. (2014)

Mechanisms of CEICH
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4221651&req=5

Fig6: Mechanisms of CEICH
Mentions: As for the radiosurgery, repetitive minor bleeding within the radionecrotic brain tissue most likely may initiate the formation of CEICH [49, 92, 96]. Nakamizo et al. [127] believes that radiosurgery could impose hypoxic stress on the surrounding brain tissue and induce a transcription of vascular endothelial growth factor, which could contribute to the abnormal angiogenesis and vascular leakage that expand the haematoma (Fig. 6).Fig. 6

Bottom Line: Haematoma expansion, intraventricular haemorrhage, perihaematomal oedema, and inflammation, can all cause an acute progression of haemorrhagic stroke.Specific 'second peak' of perihaematomal oedema after intracerebral haemorrhage and 'tension haematoma' are the primary causes of subacute progression.For the chronic progressing haemorrhagic stroke, the occult vascular malformations, trauma, or radiologic brain surgeries can all cause a slowly expanding encapsulated haematoma.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, Xiangya Second Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China.

ABSTRACT
Haemorrhagic stroke is a severe stroke subtype with high rates of morbidity and mortality. Although this condition has been recognised for a long time, the progressing haemorrhagic stroke has not received adequate attention, and it accounts for an even worse clinical outcome than the nonprogressing types of haemorrhagic stroke. In this review article, we categorised the progressing haemorrhagic stroke into acute progressing haemorrhagic stroke, subacute haemorrhagic stroke, and chronic progressing haemorrhagic stroke. Haematoma expansion, intraventricular haemorrhage, perihaematomal oedema, and inflammation, can all cause an acute progression of haemorrhagic stroke. Specific 'second peak' of perihaematomal oedema after intracerebral haemorrhage and 'tension haematoma' are the primary causes of subacute progression. For the chronic progressing haemorrhagic stroke, the occult vascular malformations, trauma, or radiologic brain surgeries can all cause a slowly expanding encapsulated haematoma. The mechanisms to each type of progressing haemorrhagic stroke is different, and the management of these three subtypes differs according to their causes and mechanisms. Conservative treatments are primarily considered in the acute progressing haemorrhagic stroke, whereas surgery is considered in the remaining two types.

Show MeSH
Related in: MedlinePlus