Progression of traumatic intracerebral hemorrhage

A prospective observational study

Raj K. Narayan, Andrew I R Maas, Franco Servadei, Brett E. Skolnick, Michael N. Tillinger, Lawrence F. Marshall, N. Badjatia, M. Cipolle, D. Duong, R. Dutton, E. Dyer, G. Fulda, M. Grady, J. Hedges, P. Hitchon, S. Levy, J. Linfoot, M. McCarthy, J. Morris, J. Muizelaar & 22 others R. Narayan, P. O'Neil, B. O'Neill, Kristine H O'Phelan, J. Sava, Z. Sifri, K. Smith, N. Theodore, S. Timmons, D. Wang, J. Ward, J. Wilberger, M. Albert, M. Cusimano, J. Fenwick, A. Kaufmann, G. Pagliarello, G. Poirier, K. Reddy, M. Chapman, B. Rowe, D. Zygun

Research output: Contribution to journalArticle

99 Citations (Scopus)

Abstract

Preliminary evidence has shown that intracerebral hemorrhages, either spontaneous (sICH) or traumatic (tICH) often expand over time. An association between hemorrhage expansion and clinical outcomes has been described for sICH. The intent of this prospective, observational study was to characterize the temporal profile of hemorrhage progression, as measured by serial computed tomography (CT) scanning, with the aim of better understanding the natural course of hemorrhage progression in tICH. There was also a desire to document the baseline adverse event (AE) profile in this patient group. An important motive for performing this study was to set the stage for subsequent studies that will examine the role of a new systemic hemostatic agent in tICH. Subjects were enrolled if they had tICH lesions of at least 2 mL on a baseline CT scan obtained within 6 h of a head injury. CT scans were repeated at 24 and 72 h. Clinical outcomes and pre-defined AEs were documented. The data showed that 51% of the subjects demonstrated an increase in tICH volume, and that most of the increase occurred early. In addition, larger hematomas exhibited the greatest expansion. Thromboembolic complications were identified in 13% of subjects. This study demonstrates that tICH expansion between the baseline and 24-h CT scans occurred in approximately half of the subjects. The earlier after injury that the initial CT scan is obtained, the greater is the likelihood that the hematoma will expand on subsequent scans. The time frame during which hemorrhagic expansion occurs provides an opportunity for early intervention to limit a process with adverse prognostic implications.

Original languageEnglish
Pages (from-to)629-639
Number of pages11
JournalJournal of Neurotrauma
Volume25
Issue number6
DOIs
StatePublished - Jun 1 2008
Externally publishedYes

Fingerprint

Traumatic Cerebral Hemorrhage
Observational Studies
Tomography
Prospective Studies
Hemorrhage
Hematoma
Cerebral Hemorrhage
Hemostatics
Craniocerebral Trauma
Wounds and Injuries

Keywords

  • Cerebral contusions
  • Deep vein thrombosis
  • Intracerebral hemorrhage
  • Thromboembolic complications
  • Traumatic brain injury

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Narayan, R. K., Maas, A. I. R., Servadei, F., Skolnick, B. E., Tillinger, M. N., Marshall, L. F., ... Zygun, D. (2008). Progression of traumatic intracerebral hemorrhage: A prospective observational study. Journal of Neurotrauma, 25(6), 629-639. https://doi.org/10.1089/neu.2007.0385

Progression of traumatic intracerebral hemorrhage : A prospective observational study. / Narayan, Raj K.; Maas, Andrew I R; Servadei, Franco; Skolnick, Brett E.; Tillinger, Michael N.; Marshall, Lawrence F.; Badjatia, N.; Cipolle, M.; Duong, D.; Dutton, R.; Dyer, E.; Fulda, G.; Grady, M.; Hedges, J.; Hitchon, P.; Levy, S.; Linfoot, J.; McCarthy, M.; Morris, J.; Muizelaar, J.; Narayan, R.; O'Neil, P.; O'Neill, B.; O'Phelan, Kristine H; Sava, J.; Sifri, Z.; Smith, K.; Theodore, N.; Timmons, S.; Wang, D.; Ward, J.; Wilberger, J.; Albert, M.; Cusimano, M.; Fenwick, J.; Kaufmann, A.; Pagliarello, G.; Poirier, G.; Reddy, K.; Chapman, M.; Rowe, B.; Zygun, D.

In: Journal of Neurotrauma, Vol. 25, No. 6, 01.06.2008, p. 629-639.

Research output: Contribution to journalArticle

Narayan, RK, Maas, AIR, Servadei, F, Skolnick, BE, Tillinger, MN, Marshall, LF, Badjatia, N, Cipolle, M, Duong, D, Dutton, R, Dyer, E, Fulda, G, Grady, M, Hedges, J, Hitchon, P, Levy, S, Linfoot, J, McCarthy, M, Morris, J, Muizelaar, J, Narayan, R, O'Neil, P, O'Neill, B, O'Phelan, KH, Sava, J, Sifri, Z, Smith, K, Theodore, N, Timmons, S, Wang, D, Ward, J, Wilberger, J, Albert, M, Cusimano, M, Fenwick, J, Kaufmann, A, Pagliarello, G, Poirier, G, Reddy, K, Chapman, M, Rowe, B & Zygun, D 2008, 'Progression of traumatic intracerebral hemorrhage: A prospective observational study', Journal of Neurotrauma, vol. 25, no. 6, pp. 629-639. https://doi.org/10.1089/neu.2007.0385
Narayan RK, Maas AIR, Servadei F, Skolnick BE, Tillinger MN, Marshall LF et al. Progression of traumatic intracerebral hemorrhage: A prospective observational study. Journal of Neurotrauma. 2008 Jun 1;25(6):629-639. https://doi.org/10.1089/neu.2007.0385
Narayan, Raj K. ; Maas, Andrew I R ; Servadei, Franco ; Skolnick, Brett E. ; Tillinger, Michael N. ; Marshall, Lawrence F. ; Badjatia, N. ; Cipolle, M. ; Duong, D. ; Dutton, R. ; Dyer, E. ; Fulda, G. ; Grady, M. ; Hedges, J. ; Hitchon, P. ; Levy, S. ; Linfoot, J. ; McCarthy, M. ; Morris, J. ; Muizelaar, J. ; Narayan, R. ; O'Neil, P. ; O'Neill, B. ; O'Phelan, Kristine H ; Sava, J. ; Sifri, Z. ; Smith, K. ; Theodore, N. ; Timmons, S. ; Wang, D. ; Ward, J. ; Wilberger, J. ; Albert, M. ; Cusimano, M. ; Fenwick, J. ; Kaufmann, A. ; Pagliarello, G. ; Poirier, G. ; Reddy, K. ; Chapman, M. ; Rowe, B. ; Zygun, D. / Progression of traumatic intracerebral hemorrhage : A prospective observational study. In: Journal of Neurotrauma. 2008 ; Vol. 25, No. 6. pp. 629-639.
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AU - Narayan, R.

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AU - O'Phelan, Kristine H

AU - Sava, J.

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AU - Smith, K.

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AU - Timmons, S.

AU - Wang, D.

AU - Ward, J.

AU - Wilberger, J.

AU - Albert, M.

AU - Cusimano, M.

AU - Fenwick, J.

AU - Kaufmann, A.

AU - Pagliarello, G.

AU - Poirier, G.

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