Blood-brain barrier compromise does not predict perihematoma edema growth in intracerebral hemorrhage

Rebecca McCourt; Bronwen Gould; Mahesh Kate; Negar Asdaghi; Jayme C Kosior; Shelagh Coutts; Michael D Hill; Andrew Demchuk; Thomas Jeerakathil; Derek Emery; Kenneth S Butcher

doi:10.1161/STROKEAHA.114.007544

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Blood-brain barrier compromise does not predict perihematoma edema growth in intracerebral hemorrhage

Journal article

Open access

Peer reviewed

Blood-brain barrier compromise does not predict perihematoma edema growth in intracerebral hemorrhage

Rebecca McCourt, Bronwen Gould, Mahesh Kate, Negar Asdaghi, Jayme C Kosior, Shelagh Coutts, Michael D Hill, Andrew Demchuk, Thomas Jeerakathil, Derek Emery, …

Stroke (1970), Vol.46(4), pp.954-960

2015-04

DOI: https://doi.org/10.1161/STROKEAHA.114.007544

PMID: 25700288

Abstract

Aged

Aged, 80 and over

Blood Pressure - drug effects

Blood-Brain Barrier - metabolism

Brain Edema - diagnostic imaging

Cerebral Hemorrhage - diagnostic imaging

Cerebrovascular Circulation - drug effects

Cerebrovascular Circulation - physiology

Contrast Media

Disease Progression

Female

Hematoma, Subdural, Intracranial - diagnostic imaging

Humans

Male

Middle Aged

Permeability

Prognosis

Radiography

There are limited data on the extent of blood-brain barrier (BBB) compromise in acute intracerebral hemorrhage patients. We tested the hypotheses that BBB compromise measured with permeability-surface area product (PS) is increased in the perihematoma region and predicts perihematoma edema growth in acute intracerebral hemorrhage patients. Patients were randomized within 24 hours of symptom onset to a systolic blood pressure (SBP) treatment of <150 (n=26) or <180 mm Hg (n=27). Permeability maps were generated using computed tomographic perfusion source data acquired 2 hours after randomization, and mean PS was measured in the hematoma, perihematoma, and hemispheric regions. Hematoma and edema volumes were measured on noncontrast computed tomographic scans obtained at baseline, 2 hours and 24 hours after randomization. Patients were randomized at a median (interquartile range) time of 9.3 hours (14.1) from symptom onset. Treatment groups were balanced with respect to baseline SBP and hematoma volume. Perihematoma PS (5.1±2.4 mL/100 mL per minute) was higher than PS in contralateral regions (3.6±1.7 mL/100 mL per minute; P<0.001). Relative edema growth (0-24 hours) was not predicted by perihematoma PS (β=-0.192 [-0.06 to 0.01]) or SBP change (β=-0.092 [-0.002 to 0.001]). SBP was lower in the <150 target group (139.2±22.1 mm Hg) than in the <180 group (159.7±12.3 mm Hg; P<0.0001). Perihematoma PS was not different between groups (4.9±2.4 mL/100 mL per minute for the <150 group, 5.3±2.4 mL/100 mL per minute for the <180 group; P=0.51). BBB permeability is focally increased in the hematoma and perihematoma regions of acute intracerebral hemorrhage patients. BBB compromise does not predict acute perihematoma edema volume or edema growth. SBP reduction does not affect BBB permeability. URL: http://www.clinicaltrials.gov. Unique identifier: NCT00963976.

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Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.105 Strokes; 1.105.142 Stroke
Web Of Science research areas: Clinical Neurology; Peripheral Vascular Disease
ESI research areas: Neuroscience & Behavior

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Title: Blood-brain barrier compromise does not predict perihematoma edema growth in intracerebral hemorrhage
Creators: Rebecca McCourt - From the Department of Medicine, Division of Neurology (R.M., B.G., M.K., J.C.K., T.J., K.S.B.) and Department of Radiology and Diagnostic Imaging (D.E.), University of Alberta, Edmonton, Canada; Division of Neurology, University of British Columbia, Vancouver, Canada (N.A.); and Department of Clinical Neurosciences, University of Calgary, Calgary, Canada (S.C., M.D.H., A.D.)
Bronwen Gould - From the Department of Medicine, Division of Neurology (R.M., B.G., M.K., J.C.K., T.J., K.S.B.) and Department of Radiology and Diagnostic Imaging (D.E.), University of Alberta, Edmonton, Canada; Division of Neurology, University of British Columbia, Vancouver, Canada (N.A.); and Department of Clinical Neurosciences, University of Calgary, Calgary, Canada (S.C., M.D.H., A.D.)
Mahesh Kate - From the Department of Medicine, Division of Neurology (R.M., B.G., M.K., J.C.K., T.J., K.S.B.) and Department of Radiology and Diagnostic Imaging (D.E.), University of Alberta, Edmonton, Canada; Division of Neurology, University of British Columbia, Vancouver, Canada (N.A.); and Department of Clinical Neurosciences, University of Calgary, Calgary, Canada (S.C., M.D.H., A.D.)
Negar Asdaghi - From the Department of Medicine, Division of Neurology (R.M., B.G., M.K., J.C.K., T.J., K.S.B.) and Department of Radiology and Diagnostic Imaging (D.E.), University of Alberta, Edmonton, Canada; Division of Neurology, University of British Columbia, Vancouver, Canada (N.A.); and Department of Clinical Neurosciences, University of Calgary, Calgary, Canada (S.C., M.D.H., A.D.)
Jayme C Kosior - From the Department of Medicine, Division of Neurology (R.M., B.G., M.K., J.C.K., T.J., K.S.B.) and Department of Radiology and Diagnostic Imaging (D.E.), University of Alberta, Edmonton, Canada; Division of Neurology, University of British Columbia, Vancouver, Canada (N.A.); and Department of Clinical Neurosciences, University of Calgary, Calgary, Canada (S.C., M.D.H., A.D.)
Shelagh Coutts - From the Department of Medicine, Division of Neurology (R.M., B.G., M.K., J.C.K., T.J., K.S.B.) and Department of Radiology and Diagnostic Imaging (D.E.), University of Alberta, Edmonton, Canada; Division of Neurology, University of British Columbia, Vancouver, Canada (N.A.); and Department of Clinical Neurosciences, University of Calgary, Calgary, Canada (S.C., M.D.H., A.D.)
Michael D Hill - From the Department of Medicine, Division of Neurology (R.M., B.G., M.K., J.C.K., T.J., K.S.B.) and Department of Radiology and Diagnostic Imaging (D.E.), University of Alberta, Edmonton, Canada; Division of Neurology, University of British Columbia, Vancouver, Canada (N.A.); and Department of Clinical Neurosciences, University of Calgary, Calgary, Canada (S.C., M.D.H., A.D.)
Andrew Demchuk - From the Department of Medicine, Division of Neurology (R.M., B.G., M.K., J.C.K., T.J., K.S.B.) and Department of Radiology and Diagnostic Imaging (D.E.), University of Alberta, Edmonton, Canada; Division of Neurology, University of British Columbia, Vancouver, Canada (N.A.); and Department of Clinical Neurosciences, University of Calgary, Calgary, Canada (S.C., M.D.H., A.D.)
Thomas Jeerakathil - From the Department of Medicine, Division of Neurology (R.M., B.G., M.K., J.C.K., T.J., K.S.B.) and Department of Radiology and Diagnostic Imaging (D.E.), University of Alberta, Edmonton, Canada; Division of Neurology, University of British Columbia, Vancouver, Canada (N.A.); and Department of Clinical Neurosciences, University of Calgary, Calgary, Canada (S.C., M.D.H., A.D.)
Derek Emery - From the Department of Medicine, Division of Neurology (R.M., B.G., M.K., J.C.K., T.J., K.S.B.) and Department of Radiology and Diagnostic Imaging (D.E.), University of Alberta, Edmonton, Canada; Division of Neurology, University of British Columbia, Vancouver, Canada (N.A.); and Department of Clinical Neurosciences, University of Calgary, Calgary, Canada (S.C., M.D.H., A.D.)
Kenneth S Butcher - From the Department of Medicine, Division of Neurology (R.M., B.G., M.K., J.C.K., T.J., K.S.B.) and Department of Radiology and Diagnostic Imaging (D.E.), University of Alberta, Edmonton, Canada; Division of Neurology, University of British Columbia, Vancouver, Canada (N.A.); and Department of Clinical Neurosciences, University of Calgary, Calgary, Canada (S.C., M.D.H., A.D.). ken.butcher@ualberta.ca
Publication Details: Stroke (1970), Vol.46(4), pp.954-960
Academic Unit: Miller School of Medicine; UMMG Department of Neurology; UMMG Dept of Neurology - Stroke Div
Language: English
Resource Type: Journal article
PMID: 25700288
Record Identifier: 991031613336702976