Background: Hematoma expansion is a detrimental event of intracerebral hemorrhage
(ICH) which results in progressive neurologic deteriorations and poor outcomes.
Objective: To summariz the current understanding of the mechanisms underlying hematoma expansion
and discuss the potential approaches of treatment and prevention.
Results: Although the exact mechanism of hematoma expansion is unclear, accumulating evidences
suggest that multiple clinical markers such as coagulation/hemostasis dysfunction, higher blood pressure
and BRAIN scores, higher serum glucose and/or glycosylated hemoglobin A1c, serum creatinine,
Factor XIII and international normalized ratio (INR), lower serum cholesterol or LDL cholesterol,
and fibrinogen, may be correlated with incidents of hematoma expansion. Furthermore, activation
of several molecular pathways (i.e. plasma kallikrein, von Willebrand factor, N-methyl-Daspartate
and its receptor, cytokines/ adipokines, cellular fibronectin and apolipoprotein Eε2 allele)
may lead to hematoma expansion.
Conclusion: Prospective study for hematoma expansion How to predict the patients Who are at highest
risk of hematoma expansion is more challengeable than restricting hematoma expansion itself following
acute ICH. Seeking and detecting risk markers in plasma that can be intervened appropriately
is meaningful for patients with potential hematoma expansion, which may contribute to improve
clinical outcomes in patients suffering from ICH.