Brain Hemorrhages最新文献

{"title":"Targeting mitochondrial NOX4/ROS to prevent hyperglycemia-induced hemorrhagic transformation after mechanical thrombectomy in acute ischemic stroke","authors":"Wensong Su ,&nbsp;Xiaoqiong Su ,&nbsp;Xuxiang Yu ,&nbsp;Guijiang Dong ,&nbsp;Junjiang Tong ,&nbsp;Xinhua Tian ,&nbsp;Zhong Liu","doi":"10.1016/j.hest.2025.11.002","DOIUrl":"10.1016/j.hest.2025.11.002","url":null,"abstract":"<div><h3>Objective</h3><div>This study examines whether mitochondrial NOX4 (mtNOX4) plays a crucial role in hemorrhagic transformation (HT) after mechanical thrombectomy (MT) in acute ischemic stroke (AIS).</div></div><div><h3>Methods</h3><div>The rat hyperglycemia-induced HT model and brain microvascular endothelial cells OGD/R model were used to simulate the process of HT after MT in human AIS. NOX4 siRNA induced NOX4 knockdown <em>in vitro</em> or NOX4 shRNA <em>in vivo</em>. MtNOX4/ROS was measured <em>in vivo</em> and <em>in vitro</em>. <em>In vitro</em>, tight junction (TJ) proteins and adhering junction (AJ) proteins were detected in endothelial cells. Infarct volume, HT, BBB damage, and neurological score were determined 24 h after cerebral ischemia <em>in vivo</em>.</div></div><div><h3>Results</h3><div>The induction of mitochondrial oxidative stress by mtNOX4/ROS disrupted AJ and TJ proteins after OGD/R. Furthermore, compared to the OGD/R group, NOX4 siRNA decreased the expression of mtNOX4/ROS and mitigated the downregulation of ZO-1, Occludin, Claudin-5, and VE-Cadherin. <em>In vivo</em> experiments demonstrated that NOX4 knockdown suppressed mtNOX4/ROS upregulation in the penumbra area compared to the HT group. Additionally, NOX4 knockdown reduced infarct volume and HT while improving BBB integrity and neurological outcomes.</div></div><div><h3>Conclusion</h3><div>Targeting the mtNOX4/ROS pathway may be a potential treatment strategy to improve outcomes in patients suffering from HT after MT for AIS.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 6","pages":"Pages 277-284"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IRRAflow active irrigation and drainage system: A glimpse into the future of cerebrospinal fluid shunts","authors":"Saif D. Salman ,&nbsp;Rabih G. Tawk ,&nbsp;Krishnan Ravindran ,&nbsp;Daniel A. Tonetti ,&nbsp;Nicholas Brandmeir ,&nbsp;Behnam Rezai Jahromi ,&nbsp;Babak Jahromi ,&nbsp;Richard W. Byrne ,&nbsp;William D. Freeman","doi":"10.1016/j.hest.2025.10.002","DOIUrl":"10.1016/j.hest.2025.10.002","url":null,"abstract":"<div><div>Chronic hydrocephalus after subarachnoid hemorrhage may become inevitable, necessitating a permanent cerebrospinal fluid shunt. We report a 40-year-old woman with SAH and a CHESS score of 6. We implemented the IRRAflow active irrigation and drainage system which expedited hemorrhage clearance in 4 days compared to one or two weeks longer with standard external ventricular drains. This system reduced the inflammatory load and preserved the arachnoid granulations, which are responsible for CSF resorption. Further, expedited recanalization of the fourth ventricle prevented an exponential increase in intracranial pressure. Collectively, these factors prevented CSF shunt dependency.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 6","pages":"Pages 339-342"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of body-mass-index on functional outcomes and bleeding volumes in patients suffering spontaneous intracerebral haemorrhage","authors":"Stefan Wanderer ,&nbsp;Attill Saemann ,&nbsp;Joshua Haegler ,&nbsp;Basil E. Grüter ,&nbsp;Julian Muff ,&nbsp;Sivani Sivanrupan ,&nbsp;Donato D’Alonzo ,&nbsp;Miriam Weiss ,&nbsp;Angelo Tortora ,&nbsp;Christian Musahl ,&nbsp;Gerrit Alexander Schubert ,&nbsp;Serge Marbacher ,&nbsp;Lukas Andereggen","doi":"10.1016/j.hest.2025.06.002","DOIUrl":"10.1016/j.hest.2025.06.002","url":null,"abstract":"<div><h3>Objective</h3><div>The association between obesity and clinical as well as radiological outcomes in patients suffering spontaneous intracerebral haemorrhage (ICH) remains unclear. The obesity paradox suggests a protective effect regarding in-hospital mortality. This study evaluates the impact of body mass index (BMI) on functional long-term outcome and bleeding volume in patients with spontaneous ICH.</div></div><div><h3>Methods</h3><div>A retrospective cohort study including all patients with spontaneous ICH between December 2017 and June 2021, aged 80 years or younger (<em>n</em> = 218), were included. Patients were dichotomized into overweight (OW, BMI ≥ 25 kg/m²) and normal weight (NW, BMI &lt; 25 kg/m²). Functional outcomes were assessed at 1, 3, 6 and 12-months follow-up. To address potential sex-related bias, we conducted exploratory post hoc analyses.</div></div><div><h3>Results</h3><div>Of 218 patients (66.04 ± 15.18 years) suffering spontaneous ICH, 115 (52.75 %) were OW (29.72 ± 3.82). Multivariate analysis revealed that independent significant predictors of a favourable 12-month functional outcome were smaller haematoma volume (<em>p</em> = 0.01) and symptom onset less than 6 h before arrival at our hospital (<em>p</em> = 0.018), whereas BMI was not, whether analysed dichotomously, continuously, or by WHO categories (<em>p</em> ≥ 0.41). Younger age showed to be a significant predictive factor for a better 12-month outcome in univariate analyses (<em>p</em> = 0.003), but lost significance in multivariate analyses (<em>p</em> = 0.14). Sex distribution (<em>n</em> = 72 females, <em>n</em> = 68 males; <em>p</em> = 1.0), NIHSS at admission (<em>p</em> = 0.69) and overweight prevalence (41.7 % vs. 55.9 %; <em>p</em> = 0.13) did not differ significantly between groups. Stratified BMI-outcome associations remained non-significant in both sexes (<em>p</em> = 0.39 for males, <em>p</em> = 0.21 for females).</div></div><div><h3>Conclusion</h3><div>Our data suggests that in patients suffering from spontaneous ICH, haematoma volume and age, are independent negative predictors for functional outcome in the long-term. BMI was not associated with 12-month outcome after adjustment, while early presentation (within 6 h of symptom onset) predicted favourable 12-month outcome.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 6","pages":"Pages 293-300"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Zero-shot multi-modal large language models v.s. supervised deep learning: A comparative analysis on CT-based intracranial hemorrhage subtyping","authors":"Yinuo Wang ,&nbsp;Kai Chen ,&nbsp;Yue Zeng ,&nbsp;Cai Meng ,&nbsp;Chao Pan ,&nbsp;Zhouping Tang","doi":"10.1016/j.hest.2025.10.004","DOIUrl":"10.1016/j.hest.2025.10.004","url":null,"abstract":"<div><h3>Objective</h3><div>Accurate identification of intracranial hemorrhage (ICH) subtypes on non-contrast CT is crucial for prognosis and treatment but remains challenging due to low contrast and blurred boundaries. This study evaluates the zero-shot performance of multi-modal large language models (MLLMs) versus traditional deep learning in ICH detection and subtyping.</div></div><div><h3>Methods</h3><div>Using 192 NCCT volumes from the RSNA dataset, we compared MLLMs (GPT-4o, Gemini 2.0 Flash, Claude 3.5 Sonnet V2) with deep learning models (ResNet50, Vision Transformer). MLLMs were prompted for ICH presence, subtype, localization, and volume estimation.</div></div><div><h3>Results</h3><div>Traditional deep learning models outperformed MLLMs in both ICH detection and subtyping. For subtyping, MLLMs showed lower accuracy, with Gemini 2.0 Flash achieving a macro-averaged precision of 0.41 and F1 score of 0.31.</div></div><div><h3>Conclusion</h3><div>While MLLMs offer enhanced interpretability through language-based interaction, their accuracy in ICH subtyping remains inferior to deep learning networks. Further optimization is needed to improve their utility in three-dimensional medical imaging.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 6","pages":"Pages 323-330"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pre-existing neuroendocrine tumors on brain tissue compliance following intracerebral hemorrhage in old spontaneously hypertensive rats","authors":"Anna C.J. Kalisvaart ,&nbsp;Frederick Colbourne","doi":"10.1016/j.hest.2025.10.005","DOIUrl":"10.1016/j.hest.2025.10.005","url":null,"abstract":"<div><h3>Objective</h3><div>Conditions associated with mass effect, such as intracranial tumors and hemorrhagic stroke (intracerebral hemorrhage; ICH), disrupt intracranial pressure (ICP) regulation by exhausting the brain’s compliance reserves. Displacement of cerebrospinal fluid, blood, and brain tissue (“tissue compliance”) can buffer ICP elevations, but these reserves are limited. Brain tumor patients face elevated ICH risk, yet how pre-existing mass effect influences acute intracranial compliance remains unclear. This study examined how chronic intracranial mass effect alters tissue compliance following acute ICH.</div></div><div><h3>Methods</h3><div>In an aged spontaneously hypertensive rat (SHR) cohort, a high incidence of spontaneous intracranial tumors were discovered. This prompted an exploratory analysis in 18 SHRs (n = 6/group: ICH-24 h, ICH-72 h, sham) to evaluate the impact of chronic mass effect on post-ICH tissue compliance. Following collagenase striatal hemorrhage, brains were collected for macroscopic and microscopic volumetric morphological analysis.</div></div><div><h3>Results</h3><div>Tissue compliance persisted in tumor-bearing animals, reflected by reduced contralateral hemisphere volume (∼6% at 24; ∼14 % at 72 h) and neuronal soma shrinkage in hippocampal and cortical regions. Despite smaller hematoma volumes, rats with tumors exhibited nearly twofold greater tissue compliance responses than non-tumor animals.</div></div><div><h3>Conclusion</h3><div>Pre-existing mass effect may modify the recruitment of intracranial compliance reserves following stroke in aged animals.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 6","pages":"Pages 285-292"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-Assisted surgery for primary brainstem Hemorrhage: A systematic review and Meta-Analysis","authors":"Xinjie Hong ,&nbsp;Yunqing Li ,&nbsp;Tao Xu ,&nbsp;Kaiwei Han ,&nbsp;Lijun Hou","doi":"10.1016/j.hest.2025.11.001","DOIUrl":"10.1016/j.hest.2025.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>This systematic review and <em>meta</em>-analysis evaluated the efficacy and safety of robot-assisted surgery for primary brainstem hemorrhage (PBSH).</div></div><div><h3>Methods</h3><div>Using the PICO framework, we compared robot-assisted surgery with conventional medical therapy regarding postoperative rebleeding, mortality, favourable functional outcomes, complications, and hematoma evacuation. A systematic search of PubMed, Web of Science, Embase, and the Cochrane Library was performed through July 2025, supplemented by manual citation screening. All five included studies were retrospective cohort studies.</div></div><div><h3>Results</h3><div>Qualitative synthesis indicated that robotic approaches achieved more precise hematoma clearance, better neurological recovery, and fewer complications compared with conservative therapy. Meta-analyses demonstrated reduced postoperative rebleeding and mortality with robot-assisted interventions. However, analyses of favourable functional outcomes and length of hospital stay demonstrated substantial heterogeneity, limiting pooled estimates. Notably, many survivors after robotic evacuation had substantial disability.</div></div><div><h3>Conclusion</h3><div>Overall, current evidence suggests that robot-assisted neurosurgery offers promising clinical benefits over conventional management in selected PBSH patients, particularly in reducing mortality. The ethical implications of life-prolonging intervention that results in substantial disability warrant discussion. Further multicentre, high-quality prospective trials are warranted to confirm these findings and refine patient selection criteria.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 6","pages":"Pages 331-338"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application and future directions of brain-computer interfaces in neurological disorders: Technological advances, clinical practices, and challenges","authors":"Qiao Deng ,&nbsp;Zhuang Fu ,&nbsp;Nai Ma ,&nbsp;Boding Wang","doi":"10.1016/j.hest.2025.09.002","DOIUrl":"10.1016/j.hest.2025.09.002","url":null,"abstract":"<div><div>Brain-Computer Interfaces (BCIs) represent an innovative frontier in technology, establishing a direct link between the brain and external devices. This rapidly evolving field is increasingly recognized as an essential tool for the diagnosis, motor function recovery, and treatment of neurological disorders. This review comprehensively covers BCI applications for neurological conditions such as motor disabilities, speech impairments, cognitive dysfunction, and sensory deficits. Key elements of the review include the operational principles of BCIs, significant technological advancements such as flexible neural interfaces and closed-loop neurostimulation, and clinical case studies with assessment metrics used in practice. Furthermore, the article explores the technical challenges and ethical considerations related to BCIs. It also discusses future trends, particularly the integration of artificial intelligence and virtual reality. Additionally, it highlights the development of personalized digital prescription systems, which deliver customized therapeutic strategies via digital platforms. This review systematically consolidates current knowledge to serve as a valuable reference for researchers and clinicians in neuroscience, neurorehabilitation, and neuroengineering. It aims to foster clinical translation and drive innovative progress in BCI technologies.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 6","pages":"Pages 306-314"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel middle meningeal artery-targeted mini-craniotomy incision and technique for treatment of chronic subdural hematoma with membranes/septations – technical note and case series","authors":"Anthony V. Nguyen ,&nbsp;Jose M. Soto ,&nbsp;Yilu Zhang ,&nbsp;Laura K. Reed ,&nbsp;Samuel A. Gearhart ,&nbsp;Jason H. Huang ,&nbsp;Dongxia Feng","doi":"10.1016/j.hest.2025.08.004","DOIUrl":"10.1016/j.hest.2025.08.004","url":null,"abstract":"<div><h3>Objective</h3><div>Subdural hematomas (SDH) requiring surgery are associated with significant morbidity in elderly patients. We describe a novel technique/incision for minimizing invasiveness and duration, minimizing recurrence by allowing for resection of subdural membranes and coagulation of the middle meningeal artery (MMA), and providing ease of conversion to a larger craniotomy if needed.</div></div><div><h3>Methods</h3><div>This was a retrospective review of patients who underwent the technique between 2020–2024. We examined the incidence of recurrence requiring re-intervention and additionally compared the cost of supplies/implants of the mini-craniotomy against other craniotomies performed for SDH evacuation and MMA embolization.</div></div><div><h3>Results</h3><div>Fifteen<!--> <!-->patients (mean age 71.8 years) underwent the novel mini-craniotomy for evacuation of mixed-density chronic SDHs. The mean SDH thickness and midline shift was 18.7 and 6.3 mm respectively. All patients had radiologic evidence of subdural membranes preoperatively. No patients developed symptomatic recurrence requiring surgical evacuation. The mean supply/implant cost of the mini-craniotomy was additionally significantly less than the cost of other craniotomies for SDH evacuation.</div></div><div><h3>Conclusion</h3><div>The described mini-craniotomy is safe, effective, utilizes a small incision, allows for MMA coagulation, provides access to coagulate and resect subdural membranes, can easily be turned into a larger trauma-sized craniotomy if necessary, and optimizes wound healing.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 6","pages":"Pages 301-305"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tongji Biobank: A High-Quality Repository Integrating Multi-Dimensional Biomedical Data","authors":"Haotong Sun ,&nbsp;Danyang Chen ,&nbsp;Shiling Chen ,&nbsp;Jian Shi ,&nbsp;Zhixian Zhao ,&nbsp;Yuhao Sun ,&nbsp;Xinyu Ma ,&nbsp;Xinran Xu ,&nbsp;Shengjie Li ,&nbsp;Yeguang Xu ,&nbsp;Yufei Zhang ,&nbsp;Qing Ye ,&nbsp;Ping Zhang ,&nbsp;Yanyan Chen","doi":"10.1016/j.hest.2025.10.003","DOIUrl":"10.1016/j.hest.2025.10.003","url":null,"abstract":"<div><div>With the advancement of biotechnology and computer technology, life sciences and medical data have grown rapidly, and research paradigms have undergone revolutionary changes. Biomedical and clinical research have entered the big data era, creating an urgent need to establish multi-dimensional, high-quality biobanks that effectively integrate multi-level clinical data and medical research data. This article introduces a large-scale, single-center, and informatized biobank established by Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. This biobank integrates a large amount of medical data since 1980, encompassing multi-dimensional information with real-time updates. The biobank employs a four-tier data governance architecture to ensure standardized data acquisition, structured processing, and normalized management, enabling efficient data utilization while maintaining data security. The repository also collaborates closely with experts in management, biology, ethics, law, clinical medicine, and other fields to establish a comprehensive application and approval process, an ethical review and management framework, and a supervisory system to ensure compliant operation. Using intracerebral hemorrhage as an example, we demonstrate some research results obtained using this biobank resource, aiming to assist potential researchers. The Tongji Biobank is openly accessible to all researchers who wish to utilize this resource for health-related studies that benefit public health.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 6","pages":"Pages 315-322"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of D-dimer in intracerebral haemorrhage outcomes","authors":"Fangfang Wang ,&nbsp;Xiaorong Zhang ,&nbsp;Tian Gao ,&nbsp;Min Jiang ,&nbsp;Zhiying Chen ,&nbsp;Xianting Luo ,&nbsp;Junmin Wang ,&nbsp;Jian Wang ,&nbsp;Xiaoping Yin ,&nbsp;Moxin Wu","doi":"10.1016/j.hest.2025.08.005","DOIUrl":"10.1016/j.hest.2025.08.005","url":null,"abstract":"<div><h3>Objective</h3><div>Activation of the coagulation and fibrinolysis system is a significant factor in secondary brain injury following spontaneous intracerebral haemorrhage (ICH). However, the relationships between plasma D-dimer, the smallest fibrinolysis-specific degradation product, and its implications for haematoma expansion (HE), in-hospital mortality, and coma at discharge in ICH patients have yet to be systematically explored, highlighting the need for further research in this area.</div></div><div><h3>Methods</h3><div>In this study, we conducted a comprehensive assessment of plasma D-dimer levels in a sample consisting of 451 patients diagnosed with ICH and 114 healthy controls. Our approach included baseline measurements, such as haematoma volume, National Institutes of Health Stroke Scale (NIHSS) scores, and Glasgow Coma Scale (GCS) scores, to evaluate and quantify neurological deficits following ICH. Logistic regression analysis was used to determine the independent relationship between plasma D-dimer levels and clinical outcomes. To investigate the role of D-dimer in secondary brain injury, we analysed the changes in plasma D-dimer levels at admission and on days 3, 7, and 14 in the ICH with HE subgroup. Finally, we conducted a prognostic evaluation based on in-hospital mortality and the rate of coma at discharge.</div></div><div><h3>Results</h3><div>The study revealed a marked increase in plasma D-dimer levels among patients with ICH compared with healthy controls (489.4 ± 1026 vs. 99.34 ± 55.09, <em>p</em> &lt; 0.0001). This increase in plasma D-dimer levels strongly correlated with the severity of haemorrhage. Additionally, logistic regression analysis indicated that elevated plasma D-dimer levels were associated with poor clinical outcomes following ICH. Notably, plasma D-dimer levels within the HE subgroup significantly increased during the acute phase of ICH. Furthermore, both in-hospital mortality and the incidence of coma at discharge progressively increased with increasing D-dimer levels.</div></div><div><h3>Conclusion</h3><div>Elevated plasma D-dimer levels in patients with ICH significantly correlate with in-hospital mortality and the rate of coma at discharge. Notably, these levels markedly increase during the acute phase of the ICH with HE subgroup. These significant findings underscore the pivotal role of D-dimer as a biomarker in secondary brain injury following ICH and offer a novel predictive indicator for clinical outcomes associated with this condition.</div></div>","PeriodicalId":33969,"journal":{"name":"Brain Hemorrhages","volume":"6 6","pages":"Pages 269-276"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145842529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}