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| Name | Class |
|---|---|
| Beijing Youyi Hospital | UNKNOWN |
| Tianjin Medical University General Hospital | OTHER |
| First Affiliated Hospital of Fujian Medical University | OTHER |
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Intracranial hemorrhage is a condition characterized by high mortality rates and suboptimal functional outcomes. It precipitates both direct brain injury and subsequent secondary injuries, including delayed cerebral ischemia, brain edema, and hydrocephalus. Complications such as cardiac injury may also arise, categorizing them within the cerebrocardiac syndrome (CCS). The clinical spectrum of CCS encompasses acute myocardial injury, acute coronary syndrome, left ventricular systolic and diastolic dysfunction, cardiac arrhythmias, and sudden cardiac death, all of which are associated with increased mortality and deterioration in patient status. The precise pathophysiological mechanisms underlying both cerebral and cardiac injuries remain enigmatic, and the implications for diagnosis and therapeutic strategies are yet to be fully explored.
In this study, we propose to enroll patients with intracranial hemorrhage who will undergo conventional treatment and comprehensive multidisciplinary evaluations. Our observational research is grounded in a multimodal omics and imaging approach, aimed at investigating both local and systemic injuries subsequent to intracranial hemorrhage. This comprehensive strategy is intended to facilitate precise diagnosis, risk stratification, and clinical decision-making, while also shedding light on the pathophysiological mechanisms involved.
The primary objectives of this research are to address the following key questions:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| patients with intracranial hemorrhage | patients with subarachnoid hemorrhage or intracerebral hemorrhage |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Multi-disciplinary assessment | Diagnostic Test | Multi-disciplinary assessment including blood tests, CSF test, electrocardiograms, ultrasound, imaging, etc |
|
| Measure | Description | Time Frame |
|---|---|---|
| Short-term cardiac events | Participants who suffer from sudden dysfunction or structural abnormalities of the heart (e.g., arrhythmias, myocardial infarct, sudden death) confirmed through:
| At discharge (assessed up to 5 days) |
| Long-term cardiac events | Participants who suffer from sudden dysfunction or structural abnormalities of the heart (e.g., arrhythmias, myocardial infarct, sudden death) confirmed through:
| 3 months post-discharge |
| Short-term delayed cerebral ischemia | Participants who suffer from secondary reduction in cerebral blood flow due to mechanisms such as vasospasm, microthrombosis, or hemodynamic disturbances, confirmed through:
| At discharge (assessed up to 5 days) |
| Long-term delayed cerebral ishemia | Participants who suffer from secondary reduction in cerebral blood flow due to mechanisms such as vasospasm, microthrombosis, or hemodynamic disturbances, confirmed through:
| 3 months post-discharge |
| Short-term brain-heart syndrome | Participants who suffer from cardiac dyafunction triggered by cerebral hemorrhage. Clinical manifestations include ECG abnormalities (ST-T changes, prolonged QT interval, arrhythmias), elevated cardiac enzymes (e.g., troponin), cardiac insufficiency (e.g., heart failure, pulmonary edema), chest pain mimicking myocardial ischemia and myocardial infarct. Some patients may develop life-threatening arrhythmias (e.g., ventricular fibrillation). Diagnostic evaluations involve:
|
| Measure | Description | Time Frame |
|---|---|---|
| Short-term modified Rankin Scale scores | The modified Rankin Scale (mRS) scores of participants evaluated by specialists. The mRS scores range form 0 to 6, with higher scores indicating worse outcomes. | At discharge (assessed up to 5 days) |
| Long-term modified Rankin Scale scores |
| Measure | Description | Time Frame |
|---|---|---|
| Lower extremity deep venous thrombosis | Participants who suffer from lower extremity deep venous thrombosis confirmed by lower vein ultrasound. | At discharge (assessed up to 5 days) |
Inclusion Criteria:
Exclusion Criteria:
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In this study, we intend to enroll patients suffering from acute intracranial hemorrhage, who will undergo both conventional therapy and comprehensive multidisciplinary evaluations.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Beijing Tiantan Hospital Affiliated to Capital Medical University | Recruiting | Beijing | Beijing Municipality | 100070 | China |
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| Second Affiliated Hospital, School of Medicine, Zhejiang University |
| OTHER |
| Gulou Hospital Affiliated to Medical College of Nanjing University | UNKNOWN |
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blood and cerebrospinal fluid (CSF)
| At discharge (assessed up to 5 days) |
| Long-term brain-heart syndrome | Participants who suffer from cardiac dyafunction triggered by cerebral hemorrhage. Clinical manifestations include ECG abnormalities (ST-T changes, prolonged QT interval, arrhythmias), elevated cardiac enzymes (e.g., troponin), cardiac insufficiency (e.g., heart failure, pulmonary edema), chest pain mimicking myocardial ischemia and myocardial infarct. Some patients may develop life-threatening arrhythmias (e.g., ventricular fibrillation). Diagnostic evaluations involve:
| 3 months post-discharge |
The modified Rankin Scale (mRS) scores of participants evaluated by specialists. The mRS scores range form 0 to 6, with higher scores indicating worse outcomes. |
| 3 months post-discharge |
| ID | Term |
|---|---|
| D013345 | Subarachnoid Hemorrhage |
| D009449 | Neurocirculatory Asthenia |
| D006333 | Heart Failure |
| D001281 | Atrial Fibrillation |
| D017202 | Myocardial Ischemia |
| D009203 | Myocardial Infarction |
| D001145 | Arrhythmias, Cardiac |
| D006849 | Hydrocephalus |
| D020301 | Vasospasm, Intracranial |
| D002543 | Cerebral Hemorrhage |
| ID | Term |
|---|---|
| D020300 | Intracranial Hemorrhages |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001008 | Anxiety Disorders |
| D001523 | Mental Disorders |
| D006331 | Heart Diseases |
| D007238 | Infarction |
| D007511 | Ischemia |
| D009336 | Necrosis |
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