Hyperacute injury marker (HARM) in primary hemorrhage

A distinct form of CNS barrier disruption

C. S. Kidwell, R. Burgess, R. Menon, S. Warach, L. L. Latour

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objective: The objective of the study was to characterize a previously unreported form of CNS barrier disruption in intracerebral hemorrhage (ICH): hyperacute injury marker (HARM). Methods: In this retrospective cohort analysis of patients presenting with primary ICH, precontrast and postcontrast MRI scans obtained within 5 days of symptom onset were analyzed. The presence of CNS barrier disruption was defined by 1) perihematomal or intrahematomal enhancement visualized on postcontrast T1-weighted MRI or 2) HARM: sulcal or ventricular hyperintensity visualized on postcontrast fluid-attenuated inversion recovery sequences (graded on a 5-point scale). Results: Forty-six patients were included in the analysis. Mean age was 65 years, median NIH Stroke Scale score was 7, and mean ICH volume was 12.2 mL (range 0.3-46.9 mL). HARM was visualized in 85% of patients, and this was moderate to severe in 50%. In all cases, the sulcal enhancement was noncontiguous with the hematoma. Of those patients with postcontrast T1- weighted imaging, perihematomal or intrahematomal contrast enhancement was visualized in 75% of patients. Conclusions: This study demonstrates that HARM occurs in intracerebral hemorrhage and that it likely represents a second type of CNS barrier disruption distinct from parenchymal postcontrast T1-weighted enhancement. Similar to T1 enhancement, this phenomenon may serve as a clinically useful biomarker to test therapies aimed at stabilizing acute ICH and CNS barrier disruption. Future studies are needed to further define the time course and prognostic implications of this finding.

Original languageEnglish (US)
Pages (from-to)1725-1728
Number of pages4
JournalNeurology
Volume77
Issue number19
DOIs
StatePublished - Nov 8 2011

Fingerprint

Cerebral Hemorrhage
Hemorrhage
Wounds and Injuries
Sequence Inversion
Hematoma
Cohort Studies
Biomarkers
Stroke
Magnetic Resonance Imaging
Enhancement
Central Nervous System
Disruption

ASJC Scopus subject areas

  • Clinical Neurology
  • Arts and Humanities (miscellaneous)

Cite this

Hyperacute injury marker (HARM) in primary hemorrhage : A distinct form of CNS barrier disruption. / Kidwell, C. S.; Burgess, R.; Menon, R.; Warach, S.; Latour, L. L.

In: Neurology, Vol. 77, No. 19, 08.11.2011, p. 1725-1728.

Research output: Contribution to journalArticle

Kidwell, CS, Burgess, R, Menon, R, Warach, S & Latour, LL 2011, 'Hyperacute injury marker (HARM) in primary hemorrhage: A distinct form of CNS barrier disruption', Neurology, vol. 77, no. 19, pp. 1725-1728. https://doi.org/10.1212/WNL.0b013e318236ef46
Kidwell, C. S. ; Burgess, R. ; Menon, R. ; Warach, S. ; Latour, L. L. / Hyperacute injury marker (HARM) in primary hemorrhage : A distinct form of CNS barrier disruption. In: Neurology. 2011 ; Vol. 77, No. 19. pp. 1725-1728.
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