Abstract Details

Title Hematoma Retraction and Perihematoma Hypodensity in Intracerebral Hemorrhage in Neutral Brains

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P01 - (-)

Poster/Presentation
Number 246

Objective

Background BACKGROUND: The temporal evolution of intracerebral hematomas and perihematoma edema in the ultra-early period on CT scans in patients with ICH is not well understood.

Design/Methods DESIGN/METHODS: One human and 6 goat cadaveric heads were used as "neutral brains" to provide physical properties of brain without any biological activity or new bleeding. ICH was induced by slow injection of 4ml to 20ml of fresh blood into the right and left basal ganglia of the brains. Serial CT scans of the heads were performed at 0, 1, 3, and 5 hours after inducing ICH. Analyze software was used to measure hematoma and perihematoma hypodensity volumes in the baseline and follow up CT scans.

Results RESULTS: The initial hematoma volumes of 11.6ml and 10.5ml in the right and left hemispheres of the cadaver brains gradually decreased to 6.6ml and 5.4ml at 5 hours, showing 43% and 48% retraction of hematoma, respectively. The volume of the perihematoma hypodensity in the right and left hemisphere increased from 2.6ml and 2.2ml in the 1 hour follow up CT scans to 4.9ml and 4.4ml in the 5 hour CT scan, respectively. Hematoma retraction was also observed in all six ICH models in goat brains. Perihematoma hypodensity was visualized in 70% of ICH in goat brains, with an increasing mean hypodensity volume of 0.4ml in the baseline CT scan to 0.8ml in the 5 hour follow up CT scan.

Conclusions CONCLUSIONS: Our study demonstrated that substrantial hematoma retraction and peri-hematoma hypodensity occurs in intracerebral hematomas in the absence of any new bleeding or biological activity of surrounding brain. Such observations suggest that active bleeding is underestimated in patients with no or small hematoma expansion and our understanding of perihematoma hypodesity needs to be reconsidered.

Authors/Disclosures
PRESENTER	No disclosure on file
Shahram Majidi, MD (Icahn School of Medicine at Mount Sinai)	Dr. Majidi has nothing to disclose.
Basit Rahim, MD (Virginia Commonwealth University Health System)	No disclosure on file
	No disclosure on file
	No disclosure on file
Hamza I. Maqsood, MD (Dept of Neurology)	Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.
	No disclosure on file

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