Phenomenon of Ultra-Early Erythrolysis in Intracranial Hemorrhage in Humans on MRI

摘要 脑出血是出血性中风的一种亚型，一旦发生就会造成毁灭性的后果 在人类身上。大体上讲，脑出血时神经元损伤有两种机制。最早的 脑损伤继发于血肿本身和损伤后24小时内的早期溶血。迟发性脑 损伤通过与巨噬细胞系统清除血肿有关的各种途径来介导。 有合理的动物模型数据验证了迟发性神经毒性的病理机制 我也是。超早期溶血是最近动物脑出血模型研究中观察到的一种新现象 作者写的。在此模型中，早期红血球溶解与T2低或等信号有很好的相关性。 脑出血后24小时内血肿内的序列和脑组织铁水平的升高 血肿周围脑组织的组织学检查。没有这样的相关现象被记录在案 在人类人口中。拟议的研究将试图证实或驳斥这一现象的存在。 超早期红血球溶解和介导性神经元损伤的原因是周围铁水平增加 核磁共振显示有血肿。不同的MRI参数，如T2*iso/非低信号 血肿、血肿周边的R2*值和FLAIR序列上的水肿量 在第1天、第14天和第30天测量，以评估是否存在超早期溶血现象 在人类受试者中，不仅在血肿后的24小时内，而且在30天内也是如此。

Abstract Intracerebral Hemorrhage is a subtype of hemorrhagic stroke that has devastating consequences when it occurs in humans. Broadly there are two mechanisms of neuronal damage that occurs in the event of an ICH. The early brain injury is secondary to the hematoma itself and early erythrolysis within 24 hours of the injury. Delayed brain injury is mediated by various pathways related to the scavenging of the hematoma by the macrophage system. There is reasonable animal model data that validates pathomechanisms of delayed neurotoxicity following an ICH. Ultra-early erythrolysis is a novel phenomenon that has been observed in a recent animal ICH model study by the authors. In this rat model there is good correlation of early erythrolysis with hypo or isointensity on T2* sequences within the hematoma within first 24 hours after an ICH and increased tissue iron levels in the perihematomal brain tissue on histology. There is no such correlative phenomenon that has been documented in the human population. The proposed study will attempt to confirm or refute the presence of the phenomenon of ultra-early erythrolysis and mediated neuronal injury due to increased iron levels in the periphery of the hematoma based on MRI. Various MRI parameters like volume of T2* iso/non-hypointensity within the hematoma, R2* value in the periphery of the hematoma and volume of edema on FLAIR sequence will be measured on day 1, day14 and day 30 to evaluate the presence of the phenomenon of ultra-early erythrolysis in ICH in human subjects, not only in the first 24 hrs but also up to 30 days following the hematoma.