title: An association of prior statin use with decreased perihematomal edema.
abstract: OBJECTIVE
  To investigate the impact of statins on perihematomal edema following spontaneous supratentorial intracerebral hemorrhage (ICH).
  
  
  BACKGROUND
  Hematoma expansion and evolution of perihematomal edema are most commonly responsible for neurological deterioration following ICH. A possible role of statins in reducing perihematomal edema has been suggested based on studies in animal models.
  
  
  METHODS
  Records of consecutive ICH patients admitted to The Johns Hopkins Hospital from 1999 to 2006 were reviewed. Patients with ICH related to trauma or underlying lesions (e.g., brain tumors, aneurysms, and arterio-venous malformations) and of infratentorial location were excluded. Absolute and relative perihematomal edema were assessed on initial head CT. Using regression analysis, the impact of prior statin use on absolute and relative edema at presentation was assessed correcting for other factors possibly impacting perihematomal edema, such as age, coagulopathy, aspirin use, admission mean arterial pressure (MAP), and blood glucose.
  
  
  RESULTS
  A total of 125 consecutive ICH patients were studied. Patients with prior statin exposure had a mean edema volume of 13.2 +/- 9.2 cc compared to 22.3 +/- 18.3 cc in patients who were not using statins at the time of ICH. Following multiple linear regression analysis, we have identified a statistically significant association between prior statin use with reduced early absolute perihematomal edema (P = 0.035). Mean relative perihematomal edema was significantly lower in patients on statins at presentation (0.44) as opposed to 0.81 in patients with no prior statin use. This difference remained statistically significant (P = 0.021) after correcting for other variables.
  
  
  CONCLUSIONS
  We report the association between statin use prior to ICH and decreased absolute and relative perihematomal edema. A prospective study analyzing the role of statins in perihematomal edema reduction and the resultant effect on mortality and functional outcomes following ICH is warranted.
authors: The Johns Hopkins Hospital, Baltimore, MD, USA. nnaval1@jhmi.edu
authors: Neeraj S
authors: NS
authors: Naval
authors: Tamer A
authors: TA
authors: Abdelhak
authors: Nathalie
authors: N
authors: Urrunaga
authors: Paloma
authors: P
authors: Zeballos
authors: Marek A
authors: MA
authors: Mirski
authors: Juan R
authors: JR
authors: Carhuapoma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000517:prevention & control; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
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