title: Temporal pattern of cytotoxic edema in the perihematomal region after intracerebral hemorrhage: a serial magnetic resonance imaging study.
abstract: OBJECTIVE
  Knowledge about cytotoxic edema (CE) in intracerebral hemorrhage is still limited. We aimed to analyze its presence, temporal pattern, and prognostic meaning.
  
  
  METHODS
  Twenty-one patients with primary intracerebral hemorrhage underwent magnetic resonance imaging at days 1, 3, and 7 after symptom onset. CE was identified using diffusion-weighted imaging. Hematoma and perihematomal edema volumes were measured on fluid-attenuated inversion recovery images. National Institutes of Health Stroke Scale score was assessed at admission and with each magnetic resonance imaging. Clinical outcome was assessed by modified Rankin scale at 90 days.
  
  
  RESULTS
  CE appeared in half of the patients within the first 24 hours. The apparent diffusion coefficient values decreased until day 3 and were significantly reversed from days 3 through 7 (P<0.01). Patients with CE showed significantly faster perihematomal edema growth from day 0 to 1 (P=0.036) than those without. Larger 3-day perihematomal edema volume (P=0.02) and presence of CE on day 3 (P=0.07) were associated with poor clinical outcome.
  
  
  CONCLUSIONS
  CE is associated with stroke severity, perihematomal edema volume, and poor outcome. It is considered to indicate ongoing neuronal injury and, thus, might emerge as new treatment target.
authors: Department of Neurology, Hannover Medical School, Hannover, Germany. selina1808@gmail.com
authors: Na
authors: N
authors: Li
authors: Hans
authors: H
authors: Worthmann
authors: Meike
authors: M
authors: Heeren
authors: Ramona
authors: R
authors: Schuppner
authors: Milani
authors: M
authors: Deb
authors: Anita B
authors: AB
authors: Tryc
authors: Eva
authors: E
authors: Bueltmann
authors: Heinrich
authors: H
authors: Lanfermann
authors: Frank
authors: F
authors: Donnerstag
authors: Karin
authors: K
authors: Weissenborn
authors: Peter
authors: P
authors: Raab
mesh_terms: D001921:Brain / Q000473:pathology; D001929:Brain Edema / Q000150:complications* / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D006406:Hematoma / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009474:Neurons / Q000378:metabolism; D011379:Prognosis; D012306:Risk; D020521:Stroke / Q000150:complications / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome