Evidence map›Paper›PMID 38040993›Full record

Trial reportNeurocritical care2024

Mechanistic Evaluation of Diffusion Weighted Hyperintense Lesions After Large Spontaneous Intracerebral Hemorrhage: A Subgroup Analysis of MISTIE III.

Lucia Rivera-Lara, Sung-Min Cho, Yunke Li, Hasan Ali, Nichol McBee, Issam A Awad, Radhika Avadhani, Daniel F Hanley, Dheeraj Gandhi, Nathan Walborn and 2 more

Abstract readClinical Trial, Phase IIIRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Neurocritical care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.6field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Observational
  5. Review
  6. Individualized autoregulation-guided arterial blood pressure management in neurocritical care.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
    Review
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 5 institutions in 1 country.

Lucia Rivera-LaraDivision of Stroke and Neurocritical Care, Department of Neurology, Stanford University, Palo Alto, CA, USA.
Sung-Min ChoDivision of Neurosciences Critical Care, Department of Neurology and Neurosurgery, Anesthesia and Critical Care Medicine, The Johns Hopkins University School of Medicine, 600 N Wolfe Street, Phipps 455, Baltimore, MD, 21287, USA.
Yunke LiBrain Injury Outcomes Center, Johns Hopkins University, Baltimore, MD, USA.
Hasan AliBrain Injury Outcomes Center, Johns Hopkins University, Baltimore, MD, USA.
Nichol McBeeBrain Injury Outcomes Center, Johns Hopkins University, Baltimore, MD, USA.
Issam A AwadDepartment of Neurological Surgery, University of Chicago Medicine, Chicago, IL, USA.
Radhika AvadhaniBrain Injury Outcomes Center, Johns Hopkins University, Baltimore, MD, USA.
Daniel F HanleyBrain Injury Outcomes Center, Johns Hopkins University, Baltimore, MD, USA.
Dheeraj GandhiDepartment of Radiology, Neurology and Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA.
Nathan WalbornBrain Injury Outcomes Center, Johns Hopkins University, Baltimore, MD, USA.
Santosh B Murthy *Clinical and Translational Neuroscience Unit, Department of Neurology and Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA.
Wendy C Ziai *Division of Neurosciences Critical Care, Department of Neurology and Neurosurgery, Anesthesia and Critical Care Medicine, The Johns Hopkins University School of Medicine, 600 N Wolfe Street, Phipps 455, Baltimore, MD, 21287, USA. weziai@jhmi.edu.ORCID 0000-0003-4548-7353
Johns Hopkins University · USCornell University · USStanford University · USUniversity of Chicago · USUniversity of Maryland, Baltimore · US

Funding

Intracerebral Hemorrhage and Increased Risk of Arterial ThromboembolismK23NS105948 · NINDS · WEILL MEDICAL COLL OF CORNELL UNIV · PI MURTHY, SANTOSH BHASKAR · 2018 to 2022
$972k
NIH HHS K23NS105948NIH HHS U01-NS080824NINDS NIH HHS K23 NS105948
6 · The paper itself

Abstract

backgroundIschemic lesions on diffusion weighted imaging (DWI) are common after acute spontaneous intracerebral hemorrhage (ICH) but are poorly understood for large ICH volumes (> 30 mL). We hypothesized that large blood pressure drops and effect modification by cerebral small vessel disease markers on magnetic resonance imaging (MRI) are associated with DWI lesions.

methodsThis was an exploratory analysis of participants in the Minimally Invasive Surgery Plus Alteplase for Intracerebral Hemorrhage Evacuation phase 3 trial with protocolized brain MRI scans within 7 days from ICH. Multivariable logistic regression analysis was performed to assess biologically relevant factors associated with DWI lesions, and relationships between DWI lesions and favorable ICH outcomes (modified Rankin Scale 0-3).

resultsOf 499 enrolled patients, 300 had MRI at median 7.5 days (interquartile range 7-8), and 178 (59%) had DWI lesions. The incidence of DWI lesions was higher in patients with systolic blood pressure (SBP) reduction ≥ 80 mm Hg in first 24 h (76%). In adjusted models, factors associated with DWI lesions were as follows: admission intraventricular hematoma volume (p = 0.03), decrease in SBP ≥ 80 mm Hg from admission to day 1 (p = 0.03), and moderate-to-severe white matter disease (p = 0.01). Patients with DWI lesions had higher odds of severe disability at 1 month (p = 0.04), 6 months (p = 0.036), and 12 months (p < 0.01). No evidence of effect modification by cerebral small vessel disease on blood pressure was found.

conclusionsIn patients with large hypertensive ICH, white matter disease, intraventricular hemorrhage volume, and large reductions in SBP over the first 24 h were independently associated with DWI lesions. Further investigation of potential hemodynamic mechanisms of ischemic injury after large ICH is warranted.

Indexed as

Cerebral HemorrhageDiffusion Magnetic Resonance ImagingTissue Plasminogen ActivatorAgedBrain IschemiaCerebral Small Vessel DiseasesFemaleFibrinolytic AgentsHumansMaleMiddle AgedFibrinolytic AgentsTissue Plasminogen ActivatorBlood pressure management after intracerebral hemorrhageIntracerebral hemorrhageWhite matter disease

Identifiers

PMID38040993
OpenAlexW4389232762

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.