ArticleNeurocritical care2024
Suboptimal Cerebral Perfusion is Associated with Ischemia After Intracerebral Hemorrhage.
Article in Neurocritical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 14 citations in OpenAlex.
- Invasive Monitoring of Cerebral Autoregulation in Aneurysmal Subarachnoid and Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2026Review
- Advances in Stereotactic Hematoma Evacuation for Hypertensive Intracerebral Hemorrhage and the Value of Multimodal Monitoring.Cerebrovascular diseases (Basel, Switzerland) · 2026Review
- Postoperative Neurocritical Care After Minimally Invasive Evacuation of Spontaneous Intracerebral Hemorrhage.Neurocritical care · 2026Review
- Temporal dynamics of ICP, PRx, CPP, and CPPopt in relation to functional outcome in spontaneous cerebellar hemorrhage.Critical care (London, England) · 2026Article
- Left Ventricular Hypertrophy and Ischemic Lesions After Intracerebral Hemorrhage.Neurocritical care · 2026Observational
- Postoperative Rebleeding: The Sword of Damocles in Minimally Invasive Surgery for Intracerebral Hemorrhage.Research (Washington, D.C.) · 2026Review
- The Relationship Between Pressure Reactivity and Cerebral Oximetry Indexes in Patients with Aneurysmal Subarachnoid Hemorrhage: A Single-Center Pilot Study.Neurocritical care · 2025Article
- Hemoglobin Decrements are Associated with Ischemic Brain Lesions and Poor Outcomes in Patients with Intracerebral Hemorrhage.Neurocritical care · 2025Article
- Individualized autoregulation-guided arterial blood pressure management in neurocritical care.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025Review
- Premorbid Blood Pressure Control Modifies Risk of DWI Lesions With Acute Blood Pressure Reduction in Intracerebral Hemorrhage.Hypertension (Dallas, Tex. : 1979) · 2024Observational
- Covert Consciousness in Acute Brain Injury Revealed by Automated Pupillometry and Cognitive Paradigms.Neurocritical care · 2024Article
- Remote diffusion-weighted imaging lesions in spontaneous intracerebral hemorrhage: research progress and new perspectives.Frontiers in neurologyReview
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundRemote ischemic lesions on diffusion-weighted imaging (DWI) occur in one third of patients with intracerebral hemorrhage (ICH) and are associated with worse outcomes. The etiology is unclear and not solely due to blood pressure reduction. We hypothesized that impaired cerebrovascular autoregulation and hypoperfusion below individualized lower limits of autoregulation are associated with the presence of DWI lesions.
methodsThis was a retrospective, single-center study of all primary ICH with intraparenchymal pressure monitoring within 10 days from onset and subsequent magnetic resonance imaging. Pressure reactivity index was calculated as the correlation coefficient between mean arterial pressure and intracranial pressure. Optimal cerebral perfusion pressure (CPPopt) is the cerebral perfusion pressure (CPP) with the lowest corresponding pressure reactivity index. The difference between CPP and CPPopt, time spent below the lower limit of autoregulation (LLA), and time spent above the upper limit of autoregulation (ULA) were calculated by using mean hourly physiologic data. Univariate associations between physiologic parameters and DWI lesions were analyzed by using binary logistic regression.
resultsA total of 505 h of artifact-free data from seven patients without DWI lesions and 479 h from six patients with DWI lesions were analyzed. Patients with DWI lesions had higher intracranial pressure (17.50 vs. 10.92 mm Hg; odds ratio 1.14, confidence interval 1.01-1.29) but no difference in mean arterial pressure or CPP compared with patients without DWI lesions. The presence of DWI lesions was significantly associated with a greater percentage of time spent below the LLA (49.85% vs. 14.70%, odds ratio 5.77, confidence interval 1.88-17.75). No significant association was demonstrated between CPPopt, the difference between CPP and CPPopt, ULA, LLA, or time spent above the ULA between groups.
conclusionsBlood pressure reduction below the LLA is associated with ischemia after acute ICH. Individualized, autoregulation-informed targets for blood pressure reduction may provide a novel paradigm in acute management of ICH and require further study.
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