Intracerebral Hemorrhage
Conditions
Keywords
Hemorrhage, Intracerebral hemorrhage (ICH)
Brief summary
Intracerebral hemorrhage is bleeding into the brain and is a major cause of stroke and other complications. Brain injury from intracerebral hemorrhage occurs in two phases. The early phase involves the mechanical compression of brain tissue by the expanding hematoma. In a later phase, brain swelling develops causing further compression that may lead to brain herniation and death. This study investigates the neuroprotective role of haptoglobin, in minimizing the development of brain swelling following intracerebral hemorrhage.
Detailed description
Intracerebral hemorrhage is bleeding into the brain parenchyma. It is a major cause of stroke, and is associated with significant morbidity and mortality. Brain injury from intracerebral hemorrhage occurs in two phases. The early phase involves the mechanical compression of brain tissue by the expanding hematoma. In a later phase, brain edema, especially perihematomal edema, develops causing further compression that may lead to brain herniation and death. Several factors are implicated in the development of brain edema, including inflammation resulting from the oxidative stress caused by iron-rich hemoglobin released from lysed erythrocytes in brain tissue. This study investigates the neuroprotective role of an acute phase reactant, haptoglobin, in minimizing the development of perihematomal edema following intracerebral hemorrhage. This protein protects brain tissue from hemoglobin degradation products by forming haptoglobin-hemoglobin complexes that are subsequently cleared by the spleen. Notably, different alleles of haptoglobin exist in humans, with varying affinities for hemoglobin. Investigating the association between the different alleles and the degree of perihematomal edema formation is the primary goal of this study. The investigators will also look at a marker of inflammation, matrix metalloproteinases, and analyze its level of expression in subjects with different alleles of haptoglobin.
Interventions
OTHERIntracerebral Hemorrhage
Spontaneous intracranial or intraparenchymal hemorrhage that occurred in a supratentorial location.
Sponsors
University of Florida
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Spontaneous intracranial or intraparenchymal hemorrhage * 18-85 years of age * Hemorrhage occurred in a supratentorial location
Exclusion criteria
* Inability to obtain consent within 3 days of hemorrhage onset * Known pregnancy * Therapeutic anticoagulation with Lovenox, Coumadin or Heparin * Prior history of therapeutic radiation to any area * Brain tumor * Hemorrhage related to trauma, aneurysm, arteriovenous malformation or other vascular malformation * Central nervous system infection * Subdural hematoma * Subarachnoid hemorrhage * Chronic immunosuppression, including steroids or chemotherapy agents * Infratentorial location * Unable to obtain MRI due to mental status or other contraindication (metal, pacemaker, etc.)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Perihematomal Edema Volume | Post-hemmorhage day 3 | Perihematomal edema will be measured by averaging the edema area over multiple slices and subtracting the hemorrhage area from the total lesion area. |
Countries
United States
Outcome results
None listed