The Effect of Diffusion Weighted Imaging Abnormalities on Outcomes in Patients With Spontaneous Intracerebral Hemorrhage
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 130
- 试验地点
- 1
- 主要终点
- Modified Rankin Scale (mRS)
研究概览
简要总结
Intracerebral hemorrhage (ICH) occurs when small arteries in the brain rupture due to weakening by age, high blood pressure, and/or elevated cholesterol. In addition to artery rupture, recent data suggests that patients with ICH are also at risk for developing occlusion of arteries during the acute phase, called ischemic strokes. Data suggests these ischemic strokes can negatively impact patient outcomes. Diffusion weighted imaging (DWI) is a sequence on Magnetic Resonance Imaging (MRI) that is a sensitive marker for ischemic strokes in the brain. In this proposal, our primary aim is examine prospectively the effect DWI abnormalities have on functional outcomes in patients with ICH. Our hypothesis is that the DWI abnormalities found on MRI of the brain lead to worse functional outcomes in patients with ICH
详细描述
Diffusion weighted imaging (DWI) is a sensitive method to assess for secondary ischemia in patients with acute brain injury. By comparing the outcomes of patients with and without DWI abnormalities, we would able to assess the impact these lesions have on functional recovery in patients with ICH. Since no direct therapies exist for this disease, DWI abnormalities may be a novel target for intervention to improve outcomes. If traditionally assessed functional outcomes are not affected by DWI, the mechanism behind these lesions would still warrant further evaluation and potential treatment. Detection of subclinical infarcts has emerged as a potential surrogate marker for subsequent risk of stroke, vascular dementia, and cognitive impairment. Furthermore, the cause behind DWI lesions in acute ICH may lead to better understanding the pathophysiologic interplay between ischemic and hemorrhagic strokes.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Prospective
入排标准
- 年龄范围
- 19 Years 至 79 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients > 18 years and < 80 years
- •Spontaneous intracerebral hemorrhage documented by CT scan
- •Less than 24 hours from time last seen normal to first medical evaluation
- •No prior clinical history of stroke (i.e. subarachnoid hemorrhage, ICH, or ischemic strokes)
排除标准
- •Pregnancy
- •History of cancer
- •Pre-admission mRS > 2
- •Glasgow Coma Scale less than 5
- •ICH secondary to aneurysm, vascular malformation, mycotic aneurysm, primary or metastatic tumor, trauma, warfarin-related ICH, acute-fibrinolytic associated ICH, or coagulopathy
- •Associated epidural or subdural hematoma
- •Surgical intervention < 48 hours from admission
- •Hemodynamic instability (need for vasopressor therapy)
- •Acute hypoxemic or hypercapnic respiratory failure
- •History of deep venous thrombosis
- •Contraindications to MRI based upon institutional safety checklist
结局指标
主要结局
Modified Rankin Scale (mRS)
时间窗: 3 months
Modified Rankin Scale (mRS)
次要结局
- Modified Rankin Scale (mRS)(6 months)
- National Institutes of Health Stroke Scale(14 days or discharge)
研究者
Rajeev K Garg
Assistant Professor of Neurological Sciences and Neurosurgery
Rush University Medical Center