Secondary Brain Injury in Intracerebral Hemorrhage

脑出血继发性脑损伤

• 批准号: 6773263
• 负责人: JESSE Claude HEMPHILL
• 金额: $ 12.15万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-07-15 至 2006-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6773263
• 关键词: brain circulation; brain disorder diagnosis; brain imaging /visualization /scanning; cardiovascular disorder diagnosis; cardiovascular disorder therapy; cerebral hemorrhage; cerebral ischemia /hypoxia; clinical trials; computed axial tomography; human subject; human therapy evaluation; hyperthermia; hypotension; intracranial pressure; longitudinal human study; magnetic resonance imaging; outcomes research; oxygen tension; patient oriented research

DESCRIPTION (provided by applicant): Acute primary non-traumatic intracerebral hemorrhage (ICH) is a common disorder for which there is currently no therapy of proven benefit in improving mortality and functional outcome. In fact, there remains controversy regarding the mechanisms by which ICH creates primary and secondary brain injury. The overall objective of this proposal is to produce a program which combines didactic teaching, mentoring, and clinical research to build upon Dr. Hemphill's training in neurologic critical care, thereby allowing him to develop into an independent clinical investigator studying mechanisms of injury and treatment of ICH. While management decisions in ischemic stroke, head trauma, and subarachnoid hemorrhage may be made based on clinical and diagnostic monitoring for secondary brain injury, the usefulness of this in ICH is not known. The overall hypothesis for this project is that secondary brain injury adversely effects outcome after ICH and that approaches that decrease secondary brain injury after ICH will improve outcome. This will be investigated through a series of studies related to clinical, neuromonitoring, and neuroimaging evaluation of secondary brain injury in ICH, culminating in a pilot clinical trial of ICH treatment. Studies will address: 1) the impact of clinical secondary brain insults (systemic hypoxia, hypotension, fever, and seizures) on outcome, 2) the influence of brain tissue hypoxia (measured through direct monitoring of brain tissue oxygen tension in the neurologic intensive care unit) on outcome, 3) the correlation between brain tissue hypoxia and ischemia on dynamic CT perfusion and MR diffusion-weighted imaging, and 4) the feasibility of targeting secondary brain injury in a pilot study of ICH treatment. This research should provide new and important information about the role of secondary brain injury in ICH. In conjunction with the didactic training and mentoring undertaken, this program will foster Dr. Hemphill's development into an independent researcher in neurologic critical care, specifically focusing on intracerebral hemorrhage.

描述（由申请人提供）：急性原发性非创伤性脑内 出血（ICH）是一种常见疾病，目前尚无治疗方法 在改善死亡率和功能结果方面的益处。实际上 关于非物质文化遗产创造原发性和 继发性脑损伤本提案的总体目标是， 该计划结合了教学，指导和临床研究， 基于Hemphill博士在神经重症监护方面的培训，从而 使他能够发展成为一名独立的临床研究者， 脑出血的损伤机制和治疗。 虽然在缺血性卒中、头部创伤和蛛网膜下腔出血中的管理决策 出血可以基于临床和诊断监测， 继发性脑损伤，这在ICH中的有用性尚不清楚。整体 该项目的假设是，继发性脑损伤 脑出血后的结局以及减少继发性脑损伤的方法 会改善预后。这将通过一系列的调查， 临床、神经监测和神经影像学评价相关研究 ICH继发性脑损伤，最终导致ICH的初步临床试验 治疗研究将涉及： 1)临床二次脑损伤（全身性缺氧， 低血压、发热和癫痫发作）对结果的影响， 2)脑组织缺氧的影响（通过直接监测 神经重症监护病房中的脑组织氧张力）对结果的影响， 3)脑组织缺氧与缺血的动态CT相关性研究 灌注和MR弥散加权成像，以及 4)在ICH的初步研究中靶向继发性脑损伤的可行性 治疗 这项研究应该提供新的重要信息， ICH继发性脑损伤。结合教学培训和 指导进行，该计划将促进博士. Hemphill的发展， 神经重症监护的独立研究员，特别关注 脑内出血