• Journal of Physiology & Pathology in Korean Medicine
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• v.24 no.6
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• pp.1027-1033
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• 2010

This study aimed to evaluate the effects of Astragali radix on brain edema of intracerebral hemorrhage(ICH)-induced rats. Brain edema following ICH was induced via the stereotaxic intrastriatal injection of bacterial collagenase type VII in Sprague-Dawley rats. Ethanol extract of Astragli radix was treated once a day for 3 days. Then brain hematoma volume and edema were examined. Immunohistochemistry was processed for iNOS, c-Fos, Bax, and HSP72 expressions in the brain sections and each immuno-labeling were calculated with image analysis. Ethanol extract of Astragli radix reduced hematoma volume(not significantly) and brain edema(significantly) ICH induced rats. Ethanol extract of Astragli radix reduced iNOS expressions, c-Fos, Bax and HSP72 positive cells significantly and reduced apoptotic bodies and swollen neurons in ICH induced rat brain. These results suggest that Astragli radix plays an inhibitory role in the hemorrhagic, inflammatory and apoptotic events induced by ICH. And it is supposed that neuroprotective effect of Astragli radix reveals by anti-apoptosis mechanism.

• Journal of Computing Science and Engineering
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• v.11 no.4
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• pp.142-151
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• 2017

Spontaneous intracerebral hemorrhage (sICH) has a high mortality rate. Research has demonstrated that sICH occurrence is related to weather conditions; therefore, this study used the decision tree method to explore the impact of climatic risk factors on sICH at different ages. The Taiwan National Health Insurance Research Database (NHIRD) and other open-access data were used in this study. The inclusion criterion was a first-attack sICH. The decision tree algorithm and random forest were implemented in R programming language. We defined a high risk of sICH as more than the average number of cases daily, and the younger, middle-aged and older groups were calculated as having 0.77, 2.26 and 2.60 cases per day, respectively. In total, 22,684 sICH cases were included in this study; 3,102 patients were younger (<44 years, younger group), 9,089 were middle-aged (45-64 years, middle group), and 10,457 were older (>65 years, older group). The risk of sICH in the younger group was not correlated with temperature, wind speed or humidity. The middle group had two decision nodes: a higher risk if the maximum temperature was >$19^{\circ}C$ (probability = 63.7%), and if the maximum temperature was <$19^{\circ}C$ in addition to a wind speed <2.788 (m/s) (probability = 60.9%). The older group had a higher risk if the average temperature was >$23.933^{\circ}C$ (probability = 60.7%). This study demonstrated that the sICH incidence in the younger patients was not significantly correlated with weather factors; that in the middle-aged sICH patients was highly-correlated with the apparent temperature; and that in the older sICH patients was highly-correlated with the mean ambient temperature. "Warm" cold ambient temperatures resulted in a higher risk of sICH, especially in the older patients.

• Journal of Korean Neurosurgical Society
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• v.48 no.2
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• pp.99-104
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• 2010

Objective : We conducted this study to evaluate the clinical impact of early enteral nutrition (EN) on in-hospital mortality and outcome in patients with critical hypertensive intracerebral hemorrhage (ICH). Methods : We retrospectively analyzed 123 ICH patients with Glasgow Coma Scale (GCS) score of 3-12. We divided the subjects into two groups : early EN group (< 48 hours, n = 89) and delayed EN group ($\geq$ 48 hours, n = 34). Body weight, total intake and output, serum albumin, Creactive protein, infectious complications, morbidity at discharge and in-hospital mortality were compared with statistical analysis. Results : The incidence of nosocomial pneumonia and length of intensive care unit stay were significantly lower in the early EN group than in the delayed EN group (p < 0.05). In-hospital mortality was less in the early EN group than in the delayed EN group (10.1% vs. 35.3%, respectively; p = 0.001). By multivariate analysis, early EN [odds ratio (OR) 0.229, 95% CI : 0.066-0.793], nosocomial pneumonia (OR = 5.381, 95% CI : 1.621-17.865) and initial GCS score (OR = 1.482 95% CI : 1.160-1.893) were independent predictors of in-hospital mortality in patients with critical hypertensive ICH. Conclusion : These findings indicate that early EN is an important predictor of outcome in patients with critical hypertensive ICH.

• Journal of Physiology & Pathology in Korean Medicine
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• v.25 no.5
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• pp.799-806
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• 2011

This study was performed in order to evaluate the neuroprotective effect of Boyanghwano-tang (BYT) water extract on intracerebral hemorrhage (ICH). ICH was induced by the stereotaxic intrastriatal injection of bacterial collagenase type IV in Sprague-Dawley rats. BYT was orally given once a day for 3 days after ICH. Hematoma volume and percentage edema were examined. As imflammatory markers, myeloperoxidase (MPO)-positive neutrophils infiltration and iNOS expression in the peri-ICH regions were examined using immunohistochemistry. As cellular damage markers, c-Fos, Bax, and HSP72 positive cells in the peri-ICH regions were measured also. BYT significantly reduced the hematoma volume and percentage edema of the ICH-induced rat brain. In the peri-hematoma regions, BYT significantly reduced MPO-positive neutrophil infiltration and iNOS expression of the ICH-induced rat brain. Additionally, BYT significantly reduced c-Fos, Bax, and HSP72 positive cells in the peri-hematoma regions of the ICH-induced rat brain. These results suggest that BYT plays a neuroprotective role against ICH through suppression of inflammatory responses, apoptosis and cellular damage.

• Investigative Magnetic Resonance Imaging
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• v.24 no.3
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• pp.154-161
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• 2020

Purpose: A CT angiography spot sign (CTA-spot) is a significant predictor of the early expansion of an intracerebral hemorrhage (ICH-Ex). Dynamic-susceptibility-contrast magnetic resonance imaging (DSC-MRI) can track the real-time leaking of contrast agents. It may be able to indicate active bleeding, like a CTA-spot. Materials and Methods: From September 2014 to February 2017, we did non-contrast CT, CTA, and DSC-MRI examinations of seven patients with acute ICH. We investigated the time from symptom onset to the first contrast-enhanced imaging. We evaluated the time course of the contrast leak within the ICH at the source image of the DSC-MRI and the volume change of ICH between non-contrast CT and DSC-MRI. We compared the number of slices showing CTA-spots and DSC-MRI leaks. Results: The CTA-spot and DSC-MRI leak-sign were present in four patients, and two patients among those showed ICH-Ex. The time from the symptom onset to CTA or DSC-MRI was shorter for those with a DSC-MRI leak or CTA-spot than for three patients without either (70-130 minutes vs. 135-270 minutes). The leak-sign began earlier, lasted longer, and spread to more slices in the patients with ICH-Ex than in those without ICH-Ex. The number of slices of the DSC-MRI leak and the number of the CTA-spot were well correlated. Conclusion: DSC-MRI can demonstrate the leakage of GBCA within hyperacute ICH, showing the good contrast between hematoma and contrast. The DSC-MRI leakage sign could be related to the hematoma expansion in patients with ICH.

• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.437-442
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• 2001

Objective : The purpose of this study was to evaluate the risk factors of hematoma enlargement in patients with spontaneous intracerebral hemorrhage(ICH). Methods : A series of 214 ICH patients diagnosed by brain CT scan in our neurosurgery department from June 1995 to July 1998 were reviewed with clinical status, past medical histories, laboratory findings, CT findings and prognosis. Results : In 27 patients(12.6%), the second CT scan showed an enlarged hematoma. Age, sex, and site of hematoma were not related to hematoma enlargement. A long interval(>6 hours) between the onset and the 1st CT scan strongly reduced the incidence of hematoma enlargement. The incidence of hematoma enlargement significantly increased in patients with previous history of hypertension, cerebral infarction and ICH. This analysis also demonstrated the following independent factors predisposed to hematoma enlargement : initial high systolic blood pressure, high serum total protein, low serum albumin, low serum sodium, prolonged prothrombin time(>14 sec) and activated partial thromboplastin time(>29.5 sec), irregular hematoma shape, and combined intraventricular hemorrhage. Prognosis in the group of hematoma enlargement showed high mortality(48.1%) and poor outcome. Conclusion : Patients with previous history of hypertension, cerebral infarction and ICH, and with high systolic blood pressure, prolonged coagulation time, irregular hematoma shape and intraventricular hemorrhage in CT scan should be observed carefully. And, early surgical therapy of large hematoma and meticulous control of blood pressure may decrease the mortality and morbidity in patients with spontaneous ICH.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.259-265
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• 2001

Objectives : Spontaneous intracerebral hemorrhage(S-ICH) is generally considered to be a mon-ophasic event. But some patients with ICH continued to bleed even after hospitalization. In order to evaluate the rebleeding and growth factor of hematoma in small volume S-ICH, 125 cases of S-ICH were reviewed retrospectively. Methods : We assesed age, sex, initial mental state, location of hemorrhage, systolic and diastolic blood pressure, blood pressure patterns, hematologic profile, trauma and stroke history, alcohol consumption and smoking history. Two subgroups-rebleeding groups versus no rebleeding groups-were compared, in terms of data analysis, with student T-test and chi-square test. Results : Substantial growth in the volume of S-ICH occurred in 21 cases(16.8%)-putamen(7 cases), thalamus(6 cases), subcortex(5 cases), cerebellum(2 cases), pons(1 case)-of the 125 patients. There was no significant difference in any of the parameters except initial systolic blood pressure(p=0.037) when patients with and without rebleeding were compared. Conclusion : The rebleeding and growth of the small volume S-ICH was related to the markedly elevated initial systolic blood pressure(${\geq}180mmHg$) and labile pattern of blood pressure.

• Journal of Korean Medicine Rehabilitation
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• v.21 no.4
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• pp.1-12
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• 2011

Objectives: This study was carried out in order to examine the effects of Gastrodiae rhizoma(GR) ethanol extract on neuronal apoptosis in intracerebral hemorrhage(ICH)-induced rats. Methods: ICH was induced by the stereotaxic intrastriatal injection of bacterial collagenase type VII in Sprague-Dawley rats. GR was orally given once a day for 3 days after ICH. Histological changes of the peri-hematoma regions were observed by cresyl vioIet staining. Bcl-2-associated X protein(Bax), B-cell blastoma 2(BcI-2) and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling(TUNEL) expressions in the affected regions were performed by immunohistochemistry. Results: 1. GR reduced apoptotic bodies and swelling neurons in the peri-hematoma regions of ICH-induced rats. 2. GR significantly reduced TUNEL positive cells in the peri-hematoma regions of ICH-induced rats. 3. GR significantly reduced Bax positive cells in the peri-hematoma regions of ICH-induced rats. 4. GR did not influence Bcl-2 expression in the peri-hematoma regions of ICH-induced rats. Conclusions: These results suggest that GR has neuroprotective effects against ICH-induced apoptosis.

• Journal of Korean Neurosurgical Society
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• v.48 no.5
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• pp.438-440
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• 2010

A 57-year-old man presented to the outpatient department with sudden bilateral hearing loss. The otological examination suggested bilateral severe sensorineural hearing loss. After several hours, the patient complained of a headache and became drowsy. The brain computed tomography showed a $3{\times}4\;cm$ intracerebral hemorrhage (ICH) of the left temporal lobe. Surgery was performed and 34 days after the procedure the patient was discharged from the hospital with severe bilateral sensorineural hearing loss (SNHL). Temporal lobe ICH should be considered in the differential diagnosis of patients with sudden bilateral hearing loss, regardless of the other neurological symptoms.

• Journal of Korean Neurosurgical Society
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• v.30 no.6
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• pp.699-704
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• 2001

Objectives : The rupture of middle cerebral artery(MCA) aneurysm usually cause or is associated with higher incidence of intracerebral hemorrhages(ICH) than any other aneurysmal ruptures. Also, the outcome of patients who had ICH is known to be worse than patients who had subarachnoid hemorrhage(SAH) only. The authors report the bleeding pattern and outcome of ruptured MCA aneurysm patients. Patients and Methods : A total 106 ruptured MCA aneurysm patients who were surgically treated were included and they were divided into 2 groups by the initial brain CT findings according to the presence or absence of ICH over 10cc in amount. The clinical data were analysed retrospectively. Results : The overall mortality was 18.9%. Among 81 patients(76.4%) who had subarachnoid hemorrhage(SAH) only, 68 patients(84%) showed favorable outcome. Twenty five patients(23.6%) had ICH over 10cc in amount with or without SAH, and among them, 11 patients(44%) showed favorable outcome. The ICH was located in temporal lobe(15 patients, 60%), frontal lobe(3, 12%), sylvian fissure(6, 24%) and frontal-temporal lobe(1, 4%). Among 15 patients who had ICH in temporal lobe, only 4 patients(26.6%) showed favorable outcome and all 3 patients who had ICH in frontal lobe showed favorable outcome. Conclusion : ICH was presented in 23.6% of ruptured MCA aneurysm patients and the prognosis of patients with ICH was worse than patients with SAH only. The ICH was located mainly in the temporal lobe and sylvian fissure.