AUTHOR=Lim-Hing Krista , Rincon Fred 

TITLE=Secondary Hematoma Expansion and Perihemorrhagic Edema after Intracerebral Hemorrhage: From Bench Work to Practical Aspects

JOURNAL=Frontiers in Neurology

VOLUME=Volume 8 - 2017

YEAR=2017

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2017.00074

DOI=10.3389/fneur.2017.00074

ISSN=1664-2295

ABSTRACT=Intracerebral hemorrhage (ICH) comprises 10-15% strokes annually in the United States. A key 
factor affecting ICH outcome is hematoma size and hematoma expansion. Although death may occur 
acutely at the sentinel ICH event, delayed neurologic deterioration often occurs with the evolution of the 
hematoma and injury of the surrounding tissue. Peri-hematoma edema (PHE) has also been implicated as a contributing factor for delayed neurologic deterioration after ICH. Cerebral edema results from both blood brain barrier disruption and local generation of osmotically active substances. Inflammatory cellular mediators, activation of the complement, by-products of coagulation and hemolysis such as thrombin and fibrin, and hemoglobin enter the brain and induce a local and systemic inflammatory reaction. These complex cascades lead to apoptosis or neuronal injury. By identifying the major modulators of cerebral edema after ICH, a therapeutic target to counter degenerative events may be forthcoming.