A nomogram to predict early hematoma expansion of hypertensive cerebral hemorrhage.

ABSTRACT: Early hematoma expansion of hypertensive cerebral hemorrhage is affected by various factors. This study aimed to clarify the risk factors and develop a nomogram to predict early hematoma expansion.A retrospective analysis was carried out in patients with hypertensive cerebral hemorrhage admitted to our institution between January 1, 2012 and December 31, 2018; the patients were divided into 2 groups according to the presence of early hematoma expansion. Univariate and multivariate analyses were performed to analyze the risk factors of hematoma expansion. The nomogram was developed based on a multivariate logistic regression model, and the discriminative ability of the model was analyzed.A total of 477 patients with hypertensive cerebral hemorrhage and with a baseline hematoma volume <30 ml were included in our retrospective analysis. The hematoma expansion rate was 34.2% (163/477). After multivariate logistic regression, 9 variables (alcohol history, Glasgow coma scale score, total serum calcium, blood glucose, international normalized ratio, hematoma shape, hematoma density, volume of hematoma on initial computed tomography scan, and presence of intraventricular hemorrhage) identified as independent predictors of hematoma expansion were used to generate the nomogram. The area under the receiver operating characteristic curve of the nomogram was 0.883 (95% confidence interval 0.851-0.914), and the cutoff score was -0.19 with sensitivity of 75.5% and specificity of 87.3%.The nomogram can accurately predict the risk of early hematoma expansion.

Association of Hypothyroidism with Hypertensive Intracerebral Hemorrhage: A Case-Control Study.

BACKGROUND: Hypothyroidism is widely thought to cause vascular endothelial disorders and atherosclerosis. The purpose of this study was to explore whether patients with hypertension and hypothyroidism may have a higher incidence of hypertensive intracerebral hemorrhage. METHODS: Cases of hypertensive intracerebral hemorrhage collected from the neurology department and neurosurgery department of our hospital from January 1, 2018, to December 31, 2018, were retrospectively collected. A case-control study was conducted on an equal number of patients with hypertension without hypertensive intracerebral hemorrhage randomly selected through age matching in the same period. The history of hypothyroidism and other common risk factors at admission was recorded. RESULTS: A total of 231 patients with hypertensive intracerebral hemorrhage were included and 231 patients with hypertension were selected for control subjects according to the age matching and random screening principles. Hypothyroidism was present in 54 patients (23.4%) and 33 matched controls (14.3%). Multivariate logistic regression analysis showed that hypothyroidism was an independent risk factor for hypertensive intracerebral hemorrhage (odds ratio, 2.29; 95% confidence interval, 1.38-3.79; P = 0.001). CONCLUSIONS: Hypothyroidism may be independently associated with hypertensive intracerebral hemorrhage. In view of the known pathophysiologic relationship between hypothyroidism and vascular endothelial dysfunction and atherosclerosis, further research and exploration are necessary.

Clinical features and prognostic factors of WHO II and III adult spinal meningiomas: analysis of 25 cases in a single center.

Spinal World Health Organization (WHO) II and III meningiomas are relatively rare, and often associated with great clinical aggressiveness and poor overall survival. There are controversies over factors affecting the prognosis of this disease. The aim of this retrospective study was to evaluate factors that may affect the therapeutic outcome and prognosis of adult high-grade spinal meningiomas by reviewing the medical records of 25 patients who were surgically treated in our hospital between 2001 and 2014. Univariate and multivariate analyses were performed to identify prognostic variables relative to patient and tumor characteristics, and treatment modalities. All 25 patients (14 men and 11 women; mean age 46.6 ± 16.1 years) underwent surgical resection. Local recurrence was occurred in 13 (52.0 %) patients, and 10 (40.0 %) patients died during the follow-up periods. The 5-year recurrence rate was 60.0 % and the 5-year survival rate was 68.0 %. The results of statistical analysis suggested that Simpson resection grade and the number of involved segments were prognostic factors related to progression-free survival and that sex, age, preoperative Frankel score, the number of involved segments and WHO grade were closely correlated with survival. Furthermore, we confirmed that the number of involved segments was the major independent factor affecting recurrence of patients with adult spinal high-grade meningiomas, and that sex, age and WHO grade were prognostic factors affecting survival but not recurrence.

DNA repair gene XRCC3 Thr241Met polymorphism and glioma risk: a meta-analysis.

BACKGROUND: The polymorphism of XRCC3 Thr241Met has been indicated to be correlated with glioma susceptibility, but study results are still debatable. The present meta-analysis was performed to investigate the association between XRCC3 Thr241Met polymorphism and glioma. METHODS: A total of 3754 glioma patients and 4849 controls from nine separate studies were involved. The pooled odds ratio (OR) and its corresponding 95% confidence interval (CI) was assessed by the random-effects model. RESULTS: The association between XRCC3 Thr241Met polymorphism and glioma was significant in the recessive model (OR = 1.36; 95% CI, 1.02 - 1.82; P = 0.03). In a stratified analysis by the ethnicity, significantly increased risk was detected in Asians (OR = 1.93; 95% CI, 1.18 - 3.17; P = 0.009). CONCLUSIONS: In conclusion, XRCC3 Thr241Met polymorphism was implied to be associated with increased glioma risk. More studies are needed to validate this result.

NMDA receptor antagonist MK-801 reduces neuronal damage and preserves learning and memory in a rat model of traumatic brain injury.

OBJECTIVE: NMDA receptor channel plays an important role in the pathophysiological process of traumatic brain injury (TBI). The present study aims to study the pathological mechanism of TBI and the impairment of learning and memory after TBI, and to investigate the mechanism of the protective effect of NMDA receptor antagonist MK-801 on learning and memory disorder after TBI. METHODS: Forty Sprague-Dawley rats (weighing approximately 200 g) were randomized into 5 groups (n = 8 in each group): control group, model group, low-dose group (MK-801 0.5 mg/kg), middle-dose group (MK-801 2 mg/kg), and high-dose group (MK-801 10 mg/kg). TBI model was established using a weight-drop head injury mode. After 2-month drug treatment, learning and memory ability was evaluated by using Morris water maze test. Then the animals were sacrificed, and brain tissues were taken out for morphological and immunohistochemical assays. RESULTS: The ability of learning and memory was significantly impaired in the TBI model animals. Besides, the neuronal caspase-3 expression, neuronal nitric oxide synthase (nNOS)-positive neurons and OX-42-positive microglia were all increased in TBI animals. Meanwhile, the number of neuron synapses was decreased, and vacuoles degeneration could be observed in mitochondria. After MK-801 treatment at 3 different dosages, the ability of learning and memory was markedly improved, as compared to that of the TBI model animals. Moreover, neuronal caspase-3 expression, OX-42-positive microglia and nNOS-positive neurons were all significantly decreased. Meanwhile, the mitochondria degeneration was greatly inhibited. CONCLUSION: MK-801 could significantly inhibit the degeneration and apoptosis of neurons in damaged brain areas. It could also inhibit TBI-induced increase in nNOS-positive neurons and OX-42-positive microglia. Impairment in learning and memory in TBI animals could be repaired by treatment with MK-801.