Neurology: Causeof cerebral hemorrhage at the remote site of venous thrombosis

Although the risk of cerebral hemorrhage (ICH) has been increased, IV has been shown to benefit recombinant tissue lysozyme progenitor activator (rtPA) within the first 4.5 hours after the onset of cerebral ischemia symptomsMost of these ICHs are hemorrhagic transformations in the infarction area, but for patients who received the rampon and other diseases such as myocardial infarction, about 2% of patients had a distant location ICH (remote ICHs, rICH)r-ICHs are more common in patients with white matter changes or microhemorrhageCerebral lobe r-ICH is more common in patients with amyloid markers, while deep r-ICH is more common in patients with hypertensionIn most cases, the potential mechanism of r-ICH is still unknown, presumably due to hemorrhagic transformation of static cerebral infarction and bleeding by local lesions such as cerebral microbleeds (cerebral microbleeds, CMB)Most studies of r-ICHs have used CT scans, which are less sensitive than MRIs to detect pre-existing brain lesionspublished their findings in Neurology in March 2020Agathe Drelon, from France, and others, to test the hypothesis that r-ICHs occur in pre-existing brain lesions after IV thrombosisresearchers looked ahead to collect cerebral ischemia patients with continuous venous thrombosis and evaluated baseline MRI results in patients with r-ICH to identify pre-existing encephalopathyof 944 patients, 24 (2.5%) had r-ICH: 14 cases of brain loe, 7 cases of deep, 3 cases of cerebral lobe and deep bleedingThe 16 cases were asymptomatic ICH, accounting for 1.75 per cent of all patients and 66.7 per cent of r-ICHOf these patients, a total of 41 rICH, 17 (41%) occurred in lesions present prior to the sofound: 6 microhemorrhages, 6 old and 1 recent infarction, and 4 in areas with high white signalsR-ICH patients are more likely to have a pedith-limited cerebral lobe CMB (P - 0.049)These patients were older (older 10 years) (P - 0.007) and had higher baseline systolic pressure (16 mmHg) (P s 0.035) and more CMBs (P s 0.007) than non-r-ICH patientsClinical characteristics (age, baseline systolic pressure) are better predictable r-ICH than imaging parameters (simple brain lobe CMB and 5 CMBs)R-ICH has a tendency to be associated with adverse prognosis the author concluded that pre-existing brain lesions were found in nearly half of r-ICH patients All of these are vascular sources, supporting the hypothesis that r-ICH occurs in pre-existing brain lesions High-field strong nuclear magnets can help identify pre-existing encephalopathy in those surface normal areas