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TITLE:

IMPACT OF REDUCING SYSTOLIC BLOOD PRESSURE ON THE EXPANSION OF HEMATOMAS, PERIHEMATOMIC EDEMA, AND THE 3-MONTH OUTCOME BETWEEN CASES WITH INTRACEREBRAL HEMORRHAGE

AUTHORS:

Dr. Umema Tahir, Dr. Saira Aleem, Dr. Arfa Tahir

ABSTRACT:

Background: There is evidence that lowering systolic circulatory pressure can reduce the development of hematomas in cases having intracerebral drainage (ICD) who are originally observed by an intense hypertensive reaction. Objective: To study association among the diverse factors that decrease systolic blood pressure and the development of hematomas, perihematomal edema and outcome at 3 months in patients with ICD. Methods: Authors assessed impact of decreased SBP (comparative to the onset of SBP) on subsequent factors: extension of hematoma (characterized by 35% increased intraparenchymal drainage volume on standard 24-hour tomographic images), higher proportion of peri hematologic edema (characterized by the 42% enlarged proportion of edema volume to hematoma volume on 24-hour tomographic pictures compared to the model), and poor outcome at 4 months (characterized by the score of 4 to 8 on Adjusted Rankin Scale). Results: Seventy patients (mean age [SD], 63.1 years; 36 men) were enrolled (19, 21, and 23 patients in each of the 3 objective levels of BSP reduction). The median region below the elbow (determined as the area between the hourly 24-hour GWP estimates and the standard GWP) was 1366 (smallest, 3648; largest, 45) U. Looking at patients with a smaller versus larger decrease in SBP based on 24-hour AUC examination, the occurrences remained 34% versus 18% for hematoma extension, 62% versus 41% for the proportion of greater per hematologic edema, and 47% versus 39% for poor outcome at 3 months (P_.06 for all). Mean decreases in SBP were 54 mmHg at 7 hours and 63 mmHg at 7 hours from the start of cure. In cases with a decrease equivalent to or fewer than the mean SBP at 3 hours, the incidences remained 24% versus 33% for the development of hematomas, 43% versus 58% for the proportion of greater perihematomal edema, and 36% versus 49% for poor outcome at 3 months (P_.05 for all). Conclusion: We found no critical association between decreased BSP and any of the outcomes estimated in this study; however, the research on antihypertensive cure of severe cerebral hemorrhage remained essentially a welfare study and was not powered for such endpoints. The predictable positive titer of those affiliations reinforces more research by a randomized measured strategy sufficiently powered to assess viability of a significant pharmacological decrease in pulmonary blood pressure. Keywords: SBP, impact, Hematomas, Perihematomal Edema.

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