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Abstract Details

Perihematomal Edema After Minimally Invasive Surgery for Intracerebral Hemorrhage: Predictors and Clinical Implications
Cerebrovascular Disease and Interventional Neurology
P6 - Poster Session 6 (5:00 PM-6:00 PM)
2-009

To evaluate predictors of perihematomal edema (PHE) after minimally invasive surgery (MIS) for intracerebral hemorrhage (ICH) and whether post-operative PHE is associated with ischemic brain lesions and poor ICH outcomes.

ICH carries high morbidity and mortality. MIS for hematoma evacuation has demonstrated clinical benefit and has been increasingly adopted. PHE contributes to secondary brain injury after ICH, but its relevance following MIS remains poorly characterized. Our prior work in MIS patients shows that lower hemoglobin concentration is associated with ischemic brain lesions and poor functional outcomes after ICH. Recent data also suggests a relationship between hemoglobin concentration and PHE.

We studied consecutive patients with spontaneous lobar or basal ganglia ICH who underwent MIS and had a post-operative brain MRI during hospitalization. PHE volume was quantified on the first post-operative brain MRI using semi-automated software. Multivariable linear regression models identified independent predictors of PHE. Logistic regression assessed associations between PHE and ischemic diffusion-weighted imaging (DWI) lesions remote from the hematoma, as well as poor modified Rankin Scale (mRS 4-6) at 6 months, adjusting for ICH severity and key clinical factors.

We studied consecutive patients with spontaneous lobar or basal ganglia ICH who underwent MIS and had a post-operative brain MRI during hospitalization. PHE volume was quantified on the first post-operative brain MRI using semi-automated software. Multivariable linear regression models identified independent predictors of PHE. Logistic regression assessed associations between PHE and ischemic diffusion-weighted imaging (DWI) lesions remote from the hematoma, as well as poor modified Rankin Scale (mRS 4-6) at 6 months, adjusting for ICH severity and key clinical factors.

In ICH patients undergoing MIS, hemoglobin concentration independently predicted worse post-operative PHE. PHE predicted ischemic brain lesions and functional outcomes. Further work is needed to clarify mechanistic links between hemoglobin, PHE, and ischemic brain lesions in ICH.
Authors/Disclosures
Fernanda Carvalho Poyraz, MD, PhD
PRESENTER 		Dr. Carvalho Poyraz has nothing to disclose.
Emma White No disclosure on file
Sisi Chen, MD No disclosure on file
Rmneek Kaur, DO (Mount Sinai Medical Center) Dr. Kaur has nothing to disclose.
Gabriela Keeton, MD Dr. Keeton has nothing to disclose.
Dana Klavansky, MD Dr. Klavansky has nothing to disclose.
Hae Young Baang, MD (Mount Sinai Health System) Dr. Baang has nothing to disclose.
John Liang, MD (Mount Sinai Health System) Dr. Liang has nothing to disclose.
Cappi Lay, MD No disclosure on file
Neha Dangayach, MD, FAAN (Icahn School of Medicine At Mount Sinai and Mount Sinai Hospital) Dr. Dangayach has nothing to disclose.
Christopher P. Kellner, MD (Mount Sinai Health System) Dr. Kellner has stock in METIS Innovative. Dr. Kellner has stock in Precision Recovery. Dr. Kellner has stock in Synchron. Dr. Kellner has stock in Fluid BioMed. Dr. Kellner has stock in Proprio. Dr. Kellner has stock in Von Vascular. Dr. Kellner has stock in E8. Dr. Kellner has stock in Borvo. Dr. Kellner has stock in Phantom Neuro. Dr. Kellner has stock in Radical. Dr. Kellner has stock in Reach Neuro. Dr. Kellner has stock in Aurenar. The institution of Dr. Kellner has received research support from Integra. The institution of Dr. Kellner has received research support from Penumbra. The institution of Dr. Kellner has received research support from Viz.AI. The institution of Dr. Kellner has received research support from ICE Neurosystems. The institution of Dr. Kellner has received research support from Irras. The institution of Dr. Kellner has received research support from Microtransponder. The institution of Dr. Kellner has received research support from Medtronic. The institution of Dr. Kellner has received research support from Longeviti. The institution of Dr. Kellner has received research support from Endostream. The institution of Dr. Kellner has received research support from CVAID.