ArticleStroke2022
Mechanism of Spontaneous Intracerebral Hemorrhage Formation: An Anatomical Specimens-Based Study.
Article in Stroke, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 29 citations in OpenAlex.
- The red cell distribution width to albumin ratio (RAR) for predicting prognosis in spontaneous intracerebral hemorrhage: a retrospective cohort study using the MIMIC-IV database.Scientific reports · 2026Article
- Injecting nerves with radiological contrast as a novel method of studying the peripheral nervous system.Journal of anatomy · 2026Article
- Parent Artery Disease-Related Stroke: What Is the Impact on Endovascular Treatment? A Narrative Review.Journal of clinical medicine · 2026Review
- Article
- Patency of the lenticulostriate and Pontine arteries after stenting of the intracranial arteries.Neurosurgical review · 2025Article
- Predictive modeling of hematoma expansion from non-contrast computed tomography in spontaneous intracerebral hemorrhage patients.medRxiv : the preprint server for health sciences · 2025Article
- Analysis of associated factors affecting hematoma evacuation rates in spontaneous intracerebral hemorrhage with stereotactic aspiration combined with catheter drainage.Scientific reports · 2025Article
- CSF outflow from the human spinal canal: preliminary results from an anatomical specimen-based model.Fluids and barriers of the CNS · 2025Article
- Principles of reversal of anticoagulation in patients with intracerebral hemorrhage related to oral anticoagulants.European stroke journal · 2025Review
- Complex congenital heart and lung defects as a cause of hydrops fetalis in French bulldogs -micro-CT with contrast study.Scientific reports · 2025Article
- Inhibition of tumor necrosis factor receptor-associated factor 6 alleviates secondary brain injury by reducing neuronal pyroptosis after intracerebral hemorrhage.Experimental animals · 2025Article
- Statistical analysis of the measured strength parameters of the fresh main intracranial arteries.Frontiers in bioengineering and biotechnology · 2025Article
- Narrowings of the Deep Cerebral Perforating Arteries Ostia: Geometry, Structure, and Clinical Implications.Journal of stroke · 2025Article
- Clinical and Imaging Predictors of Hematoma Expansion in Spontaneous Intracerebral Hemorrhage: Development of a Prognostic Model.Risk management and healthcare policy · 2025Article
- Anatomy of the pontine arteries and perforators of the basilar artery in humans.Journal of anatomy · 2023Article
- Perihematomal edema after minimally invasive surgery: a matter of concern to neurosurgeons.Neurosurgical review · 2023Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite advances in understanding various risk and prognostic factors, spontaneous intracerebral hemorrhage is connected to very high morbidity and mortality, while the therapy is mainly supportive. Understanding of the pathophysiology of initial hematoma expansion is limited due to insufficient clinical data and lack of a suitable animal model.
methodsWe injected 40 anatomic specimens of the basal ganglia with contrast medium, scanned them with a micro-computed tomography scanner and analyzed the results of radiological studies, direct and histological examinations.
resultsIn 9 cases, micro-computed tomography and histological examinations revealed contrast medium extravasations mimicking intracerebral hematomas. The artificial hematomas spread both proximally and distally along the ruptured perforator and its branches in the perivascular spaces and detached the branches from the adjacent neural tissue leading to destruction of the tissue and secondary extravasations. Moreover, some contrast extravasations skipped to the perivascular spaces of unruptured perforators, created further extravasation sites and aggravated the expansion of the artificial hematoma. There was no subarachnoid extension of any artificial hematoma.
conclusionsWe postulate that a forming basal ganglia intracerebral hematoma spreads initially in the perivascular space, detaches the branches from the neural tissue and causes secondary bleeding. It can also skip to the perivascular space of a nearby perforator. The proposed mechanism of hematoma initiation and formation explains extent of damage to the neural tissue, variability of growth in time and space, creation of secondary bleeding sites, and limited usefulness of surgical interventions. The model is reproducible, the extent of the artificial hematoma can be easily controlled, the rupture sites of the perforating arteries can be determined, and preparation of the model does not require specialized, expensive equipment apart from the micro-computed tomography scanner.
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