Publications (2)4.65 Total impact
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Article: Intracranial pressure variability predicts short-term outcome after intracerebral hemorrhage: A retrospective study.
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ABSTRACT: INTRODUCTION: Elevated intracranial pressure (ICP) is generally observed in brain injury and intracerebral hemorrhage (ICH) patients and is consistently associated with poor neurological outcome. Intracranial pressure variability (IPV) is a better predictor of long-term neurological outcome than mean ICP in traumatic brain injury patients. However, whether IPV regulates functional outcome in ICH patients has not been investigated. In the present study, we investigated the relationship between IPV and functional outcome in ICH patients and determined whether IPV is a valid predictor of neurological outcome in ICH patients. METHODS: A consecutive series of 56 patients with ICH were enrolled in this study. These patients underwent surgical treatments and were planted with an ICP monitor. The ICP was continuously recorded for 7days at one-hour intervals. The mean arterial blood pressure (MAP) and cerebral perfusion pressure (CPP) were also calculated. We used successive variation (SV) to represent IPV, which was calculated by averaging the difference in ICP between successive parameters. The short-term outcome was dichotomized into improved and deteriorated groups based on the changes in their Glasgow Coma Scale (GCS) score between admission and 30days after admission. The long-term outcome was evaluated by Glasgow Outcome Scale (GOS) at 12months after discharge from the hospital, and the patients were dichotomized into independent and dependent groups. RESULTS: The results showed that IPV was lower in the improved patient group and higher in patients with poorer outcome at 30days after ICH. There was a significant positive correlation between SV and short-term neurological outcome. We also found the in-patient mortality was significantly increased in the high IPV patient group (P=0.02), which was divided by the cutoff point using receiver operating characteristic (ROC) curve analysis. The univariate correlation analysis demonstrated that the IPV levels were positively correlated with mean ICP (R(2)=0.652, P=0.000), while were negatively correlated with CPP (R(2)=0.426, P=0.000). Increases in SV of ICP were a predictor of 30-day poor short-term outcome, but not for 12-month long-term outcome after adjusting for the potential confounders in a multivariable logistic regression model. CONCLUSIONS: The results suggest that high IPV is correlated with poorer outcome in ICH patients. Managing the ICP at an appropriate level during the early phase after ICH may improve functional outcome in ICH patients.Journal of the neurological sciences 04/2013; · 2.32 Impact Factor -
Article: Effects of atorvastatin in the regulation of circulating EPCs and angiogenesis in traumatic brain injury in rats.
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ABSTRACT: Circulating endothelial progenitor cells (EPCs) play an important role in angiogenesis and vasculogenesis. Statins administered promote functional improvement in rats, independent of their capability to lower cholesterol. Whether statin treatment regulates circulating EPCs after traumatic brain injury (TBI) has not been investigated. We hypothesized that atorvastatin increases circulating EPCs and promotes angiogenesis in TBI rats. Wistar rats (20 months old) were subjected to TBI and treated with or without atorvastatin (orally administered, 1mg/kg/day) starting 1h after TBI and then daily for 14 consecutive days. Long term potentiation (LTP) in the cornu ammonis1 of the hippocampus as well as the Modified Neurological Severity Score (mNSS) and the Morris Water Maze (MWM) functional tests were performed. Blood circulating EPCs were identified by flow cytometry. Rats were sacrificed 25 days after TBI. vWF and CD31 immunostaining was performed. We found that atorvastatin administration significantly induced angiogenesis and increased circulating EPC levels as well as improved functional recovery when compared with non-treatment TBI-control rats (P<0.05). The circulating EPC level is correlated with vascular density (r=0.878, P <0.05) and CD31 positive cell number in the injured brain (r=0.921, P <0.05). The results suggest that increasing circulating EPCs with atorvastatin treatment may contribute to the observed increase in angiogenesis and improved functional outcome after TBI.Journal of the neurological sciences 06/2012; 319(1-2):117-23. · 2.32 Impact Factor
