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Current approaches to diagnosing in intracerebral hemorrhage

https://doi.org/10.14412/2074-2711-2020-2-4-11

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Abstract

Intracerebral hemorrhage (ICH) is the same etiologically heterogeneous variant of stroke as cerebral infarction. The most common causes of the disease are hypertensive and cerebral amyloid microangiopathy, the use of oral anticoagulants (OACs) and their combination, and arteriovenous malformations, which are of the greatest importance for young patients. The SMASH-U or H-ATOMIC classification of ICH requires a structured diagnostic search that includes an analysis of the clinical presentations of the disease and neuroimaging and angiographic findings. Although brain computed tomography remains a basic diagnostic technique for ICH, most patients need brain magnetic resonance imaging, by mandatorily assessing the ischemic and hemorrhagic markers of cerebral small vessel diseases. This examination is necessary not only to verify the cause of ICH and to select the appropriate method of its treatment, but also to determine the risk of recurrent hemorrhage. The article considers the epidemiology and etiological characteristics of ICH and approaches to its classification. It characterizes the most significant causes of the disease, such as hypertensive and cerebral amyloid angiopathy, vessel structural abnormalities, and the use of OACs. The
diagnosis of ICH and its clinical neuroimaging diagnostic algorithm are presented.


About the Author

A. A. Kulesh
Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia
Russian Federation
2, Kim St., Perm 614107, Russia



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37. Kalashnikova LA, Gulevskaya TS, Dobrynina LA. Current problems of brain pathology in cerebral microangiopathy. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2018; 118(2):90-9. (In Russ.)

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40. Kulesh AA, Drobakha VE, Shestakov VV. Cerebral small vessel disease: classification, clinical manifestations, diagnosis, and features of treatment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(3S):4-17. (In Russ.) doi: 10.14412/2074-2711-2019-3S-4-17

41. Kulesh AA, Drobakha VE, Shestakov VV. Cerebral small vessel disease: classification, clinical manifestations, diagnosis, and features of treatment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(3S):4-17. (In Russ.) doi: 10.14412/2074-2711-2019-3S-4-17

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60. Charidimou A, Imaizumi T, Moulin S, et al. Brain hemorrhage recurrence, small vessel disease type, and cerebral microbleeds: a metaanalysis. Neurology. 2017 Aug 22;89(8):820-829. doi: 10.1212/WNL.0000000000004259. Epub 2017 Jul 26.

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62. Kulesh AA, Drobakha VE, Sobyanin KV, et al. Role of cerebral reserve assessed using diffusion-weighted magnetic resonance imaging in determining the rehabilitation potential of acute ischemic stroke. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(3):26-34. (In Russ.) doi: 10.14412/2074-2711-2019-3-26-34

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65. Ostroumova TM, Parfenov VA, Ostroumova OD, et al. Possibilities of contrast-free magnetic resonance perfusion imaging for the detection of early brain damage in essential hypertension. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2018;10(1):17-23. (In Russ.) doi: 10.14412/2074-2711-2018-1-17-23

66. Charidimou A, Boulouis G, Roongpiboonsopit D, et al. Cortical superficial siderosis and recurrent intracerebral hemorrhage risk in cerebral amyloid angiopathy: Large prospective cohort and preliminary meta-analysis. Int J Stroke. 2019 Oct;14(7):723-733. doi: 10.1177/1747493019830065. Epub 2019 Feb 20.

67. Charidimou A, Martinez-Ramirez S, Reijmer YD, et al. Total Magnetic Resonance Imaging Burden of Small Vessel Disease in Cerebral Amyloid Angiopathy: An ImagingPathologic Study of Concept Validation. JAMA Neurol. 2016 Aug 1;73(8):994-1001. doi: 10.1001/jamaneurol.2016.0832.

68. Charidimou A, Martinez-Ramirez S, Reijmer YD, et al. Total Magnetic Resonance Imaging Burden of Small Vessel Disease in Cerebral Amyloid Angiopathy: An ImagingPathologic Study of Concept Validation. JAMA Neurol. 2016 Aug 1;73(8):994-1001. doi: 10.1001/jamaneurol.2016.0832.

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80. Charidimou A, Boulouis G, Xiong L, et al. Cortical Superficial Siderosis Evolution. Stroke. 2019 Apr;50(4):954-962. doi: 10.1161/STROKEAHA.118.023368.

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83. Charidimou A, Imaizumi T, Moulin S, et al. Brain hemorrhage recurrence, small vessel disease type, and cerebral microbleeds: a metaanalysis. Neurology. 2017 Aug 22;89(8):820-829. doi: 10.1212/WNL.0000000000004259. Epub 2017 Jul 26.

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85. Charidimou C, Boulouis G, Roongpiboonsopit D, et al. Cortical superfical siderosis multifocality in cerebral amyloid angiopathy: a prospective study. Neurology. 2017 Nov 21;89(21):2128-2135. doi: 10.1212/WNL.0000000000004665. Epub 2017 Oct 25.

86. Charidimou C, Boulouis G, Roongpiboonsopit D, et al. Cortical superfical siderosis multifocality in cerebral amyloid angiopathy: a prospective study. Neurology. 2017 Nov 21;89(21):2128-2135. doi: 10.1212/WNL.0000000000004665. Epub 2017 Oct 25.

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88. Charidimou A, Boulouis G, Roongpiboonsopit D, et al. Cortical superficial siderosis and recurrent intracerebral hemorrhage risk in cerebral amyloid angiopathy: Large prospective cohort and preliminary meta-analysis. Int J Stroke. 2019 Oct;14(7):723-733. doi: 10.1177/1747493019830065. Epub 2019 Feb 20.

89. Charidimou A, Boulouis G, Roongpiboonsopit D, et al. Cortical superficial siderosis and recurrent intracerebral hemorrhage risk in cerebral amyloid angiopathy: Large prospective cohort and preliminary meta-analysis. Int J Stroke. 2019 Oct;14(7):723-733. doi: 10.1177/1747493019830065. Epub 2019 Feb 20.

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For citation:


Kulesh A.A. Current approaches to diagnosing in intracerebral hemorrhage. Neurology, Neuropsychiatry, Psychosomatics. 2020;12(2):4-11. (In Russ.) https://doi.org/10.14412/2074-2711-2020-2-4-11

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