Introduction: Neuromonitoring analysis for intracerebral hemorrhage (ICH) is still rare, especially regarding vascular reactivity patterns. Our goal was to analyze neuromonitoring data and 28-day mortality for ICH patients.
Methods: Neuromonitoring records were retrospectively reviewed from a cohort of ICH patients admitted to a neurocritical care unit between 2013 and 2016. Variables considered were intracranial pressure (ICP), cerebral perfusion pressure (CPP), optimal CPP, and pressure reactivity index (PRx), as well as ICP dose, PRx dose, and time percentage above critical value (T%abv). Information regarding demographics, surgical drainage, external ventricular drain placement, and 28-day mortality was recorded. Statistical analysis was performed using the t-test and Kaplan-Meier curves.
Results: Forty-six patients were analyzed, with a mean of 263 ± 173 h of signal records and a median length of stay in the intensive care unit of 22 (interquartile range of 13) days. The mean age was 62.6 ± 11.8 years old, and 24 (52%) of the patients were male. Patients who died within 28 day (37.0%) had significantly higher mean ICP, PRx, ICP dose, PRx dose, and T%abv. Although their mean ICP was under 20 mmHg, they presented PRx > 0.25, indicating impaired cerebrovascular reactivity (0.30 ± 0.26). Also, patients with PRx > 0.25 had a lower survival rate, with a proportion of 14% at 28 days, as opposed to 85% of those with PRx < 0.25 (p < 0.001).
Conclusion: The data suggest that autoregulation indexes are associated with 28-day mortality for ICH patients.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/978-3-030-59436-7_37 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Impaired cerebral microvascular reactivity and endothelial SK channel activity in a streptozotocin-treated mouse model of Alzheimer's disease.
J Alzheimers Dis
January 2025
Division of Cardiothoracic Surgery, Rhode Island Hospital, Alpert Medical School of Brown University, Providence, RI, USA.
Article Synopsis
- Alzheimer's disease (AD) is characterized by various pathological features including amyloid-β deposition and tau hyperphosphorylation, with cerebral microvascular dysfunction likely playing a role in its progression.
- Researchers investigated the microvascular responses and potassium channel activity in an AD mouse model induced by streptozotocin (STZ), using behavioral tests and cellular assays.
- The study found that STZ-AD mice showed poorer performance on behavioral tests and had impaired microvascular responses, which were further deteriorated by exposure to soluble Aβ, indicating a potential link between microvascular dysfunction and AD pathology.
Association of Medial Temporal Lobe Cerebrovascular Reactivity and Memory Function in Older Adults With and Without Cognitive Impairment.
Neurology
January 2025
Leonard Davis School of Gerontology, University of Southern California, Los Angeles.
Background And Objectives: Cerebrovascular reactivity (CVR) represents the ability of cerebral blood vessels to regulate blood flow in response to vasoactive stimuli and is related to cognition in cerebrovascular and neurodegenerative conditions. However, few studies have examined CVR in the medial temporal lobe, known to be affected early in Alzheimer disease and to influence memory function. We aimed to examine whether medial temporal CVR is associated with memory function in older adults with and without mild cognitive impairment (MCI).
View Article and Find Full Text PDFPeriodontitis Increases Gingival, Serum and Hippocampus β-Amyloid Expressions but Reduces Neurovascular Coupling in Basilar Artery of Rats.
J Clin Periodontol
January 2025
School of Medicine, Tzu Chi University, Hualien, Taiwan, ROC.
Aim: Neurodegenerative diseases are characterized by early increased beta-amyloid (Aβ) and decreased cerebrovascular reactivity. We investigated Aβ in gingiva, serum or hippocampus and neurovascular reactivity in basilar artery (BA) of periodontitis rats, to test the impact of Aβ on BA vasoreactivity ex vivo.
Materials And Methods: Periodontitis was induced in 32 rats using silk-ligation.
Compromised cerebrovascular reactivity related to presence of white matter hyperintensities in cryptogenic stroke with right-to-left shunts.
J Stroke Cerebrovasc Dis
January 2025
Department of Neurology, The Affiliated Hospital of Qingdao Univeisity, Qingdao 266000, Shandong, PR China. Electronic address:
Objective: This study investigates cerebrovascular reactivity (CVR) changes in cryptogenic stroke (CS) patients with right-to-left shunts (RLS) and evaluates the relationship between CVR and white matter hyperintensities (WMHs).
Methods: The breath-holding index (BHI), representing CVR, was measured from the middle cerebral artery (MCA) using the breath-holding method. WMHs were defined as clearly hyperintense areas on 3T magnetic resonance imaging (MRI), assessed separately as periventricular hyperintensities (PVH) and deep white matter hyperintensities (DWMH).
Development of an Active Cerebrovascular Autoregulation Model Using Representation Learning: A Proof of Concept Study With Experimental Data.
Neurosurgery
January 2025
Department of Neurosciences, Experimental Neurosurgery and Neuroanatomy, KU Leuven, Leuven, Belgium.
Background And Objectives: It remains a challenge to monitor cerebrovascular autoregulation (CA) reliably and dynamically in an intensive care unit. The objective was to build a proof-of-concept active CA model exploiting advances in representation learning and the full complexity of the arterial blood pressure (ABP) and intracranial pressure (ICP) signal and outperform the pressure reactivity index (PRx).
Methods: A porcine cranial window CA data set (n = 20) was used.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!