Volume Measurement and Progression Surveillance of Intracerebral Haemorrhage Using Transcranial Ultrasound

NCT ID: NCT01472224

Last Updated: 2013-07-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

30 participants

Study Classification

OBSERVATIONAL

Study Start Date

2011-10-31

Study Completion Date

2012-12-31

Brief Summary

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This study investigates the ability of ultrasound to measure the volume of a brain hemorrhage in the acute phase after hospital admission.

It is known that approximately 30% of patients admitted with a brain hemorrhage will suffer from enlargement of the hematoma within the first hours after admission.

In this study the investigators measure the volume of the hematoma every 30 minutes up to 6 hours after admission and every 2 hours between 6-12 hours.

Detailed Description

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This study investigates the use of transcranial ultrasound (TCU) for the surveillance of patients with intracerebral hemorrhages. Using transcranial ultrasound makes it possible to visualize and follow the bleeding progression through 3 points of the scull where the bone is thin enough to allow the penetration of sound waves. This can be done at bedside. Today the investigators do not know for sure if clinical parameters determine a haematoma expansion. TCU will allow us to follow the haematoma progression serially in the acute phase and relate the haematoma expansion to parameters like blood pressure, neurological status (NIHSS-score) and radiological signs of ongoing bleeding (spot signs) on CT-angiogram (CTA).

Hypothesis:

1. Bedside ultrasound volume assessment is accurate in estimating the haematoma volume compared to computer tomography (CT) and can dynamically document the haematoma expansion.
2. The haematoma expansion is accompanied by neurological deterioration and happens only with patients with CT demonstrated spot signs.
3. The haematoma expansion is observed with patients with high blood pressure.

Aim of study:

1. To validate the accuracy of ultrasound (US) compared to CT in estimating haematoma volume with ICH patients.
2. To measure ICH volume serially in the acute phase using US and up to 12 hours aiming at:

* Describing the timing of the haematoma expansion.
* Relating to neurological deterioration, systemic blood pressure and detection of spot signs on CTA.

Conditions

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Stroke Cerebral Hemorrhage

Study Design

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Study Time Perspective

PROSPECTIVE

Eligibility Criteria

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Inclusion Criteria

* Patients admitted to Bispebjerg Hospital stroke unit with CT demonstrated spontaneous ICH
* Hospital admission within 4,5 hours after symptom onset
* CTA on admission
* GCS\>8 (non-comatose)

Exclusion Criteria

* Lack of informed consent
* Underlying Pathology (tumor, AVM, aneurism)
* Lack of temporal bone window
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bispebjerg Hospital

OTHER

Sponsor Role lead

Responsible Party

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Hanne Christensen

Associate Research Professor, Consultant neurologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hanne Christensen, MD, Ph.D, DMSci

Role: PRINCIPAL_INVESTIGATOR

Bispebjerg Hospital - Department of neurology

Locations

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Bispebjerg Hospital, Neurologisk afdeling

Copenhagen, Region H, Denmark

Site Status

Countries

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Denmark

References

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Mayer SA, Rincon F. Treatment of intracerebral haemorrhage. Lancet Neurol. 2005 Oct;4(10):662-72. doi: 10.1016/S1474-4422(05)70195-2.

Reference Type BACKGROUND
PMID: 16168935 (View on PubMed)

Brott T, Broderick J, Kothari R, Barsan W, Tomsick T, Sauerbeck L, Spilker J, Duldner J, Khoury J. Early hemorrhage growth in patients with intracerebral hemorrhage. Stroke. 1997 Jan;28(1):1-5. doi: 10.1161/01.str.28.1.1.

Reference Type BACKGROUND
PMID: 8996478 (View on PubMed)

Broderick JP, Brott TG, Duldner JE, Tomsick T, Huster G. Volume of intracerebral hemorrhage. A powerful and easy-to-use predictor of 30-day mortality. Stroke. 1993 Jul;24(7):987-93. doi: 10.1161/01.str.24.7.987.

Reference Type BACKGROUND
PMID: 8322400 (View on PubMed)

Davis SM, Broderick J, Hennerici M, Brun NC, Diringer MN, Mayer SA, Begtrup K, Steiner T; Recombinant Activated Factor VII Intracerebral Hemorrhage Trial Investigators. Hematoma growth is a determinant of mortality and poor outcome after intracerebral hemorrhage. Neurology. 2006 Apr 25;66(8):1175-81. doi: 10.1212/01.wnl.0000208408.98482.99.

Reference Type BACKGROUND
PMID: 16636233 (View on PubMed)

Leira R, Davalos A, Silva Y, Gil-Peralta A, Tejada J, Garcia M, Castillo J; Stroke Project, Cerebrovascular Diseases Group of the Spanish Neurological Society. Early neurologic deterioration in intracerebral hemorrhage: predictors and associated factors. Neurology. 2004 Aug 10;63(3):461-7. doi: 10.1212/01.wnl.0000133204.81153.ac.

Reference Type BACKGROUND
PMID: 15304576 (View on PubMed)

Ohwaki K, Yano E, Nagashima H, Hirata M, Nakagomi T, Tamura A. Blood pressure management in acute intracerebral hemorrhage: relationship between elevated blood pressure and hematoma enlargement. Stroke. 2004 Jun;35(6):1364-7. doi: 10.1161/01.STR.0000128795.38283.4b. Epub 2004 Apr 29.

Reference Type BACKGROUND
PMID: 15118169 (View on PubMed)

Kothari RU, Brott T, Broderick JP, Barsan WG, Sauerbeck LR, Zuccarello M, Khoury J. The ABCs of measuring intracerebral hemorrhage volumes. Stroke. 1996 Aug;27(8):1304-5. doi: 10.1161/01.str.27.8.1304.

Reference Type BACKGROUND
PMID: 8711791 (View on PubMed)

Thompson AL, Kosior JC, Gladstone DJ, Hopyan JJ, Symons SP, Romero F, Dzialowski I, Roy J, Demchuk AM, Aviv RI; PREDICTS/Sunnybrook ICH CTA Study Group. Defining the CT angiography 'spot sign' in primary intracerebral hemorrhage. Can J Neurol Sci. 2009 Jul;36(4):456-61. doi: 10.1017/s0317167100007782.

Reference Type BACKGROUND
PMID: 19650356 (View on PubMed)

Becker G, Winkler J, Hofmann E, Bogdahn U. Differentiation between ischemic and hemorrhagic stroke by transcranial color-coded real-time sonography. J Neuroimaging. 1993 Jan;3(1):41-7. doi: 10.1111/jon19933141.

Reference Type BACKGROUND
PMID: 10148076 (View on PubMed)

Kern R, Kablau M, Sallustio F, Fatar M, Stroick M, Hennerici MG, Meairs S. Improved detection of intracerebral hemorrhage with transcranial ultrasound perfusion imaging. Cerebrovasc Dis. 2008;26(3):277-83. doi: 10.1159/000147456. Epub 2008 Jul 23.

Reference Type BACKGROUND
PMID: 18648201 (View on PubMed)

Maurer M, Shambal S, Berg D, Woydt M, Hofmann E, Georgiadis D, Lindner A, Becker G. Differentiation between intracerebral hemorrhage and ischemic stroke by transcranial color-coded duplex-sonography. Stroke. 1998 Dec;29(12):2563-7. doi: 10.1161/01.str.29.12.2563.

Reference Type BACKGROUND
PMID: 9836768 (View on PubMed)

Perez ES, Delgado-Mederos R, Rubiera M, Delgado P, Ribo M, Maisterra O, Ortega G, Alvarez-Sabin J, Molina CA. Transcranial duplex sonography for monitoring hyperacute intracerebral hemorrhage. Stroke. 2009 Mar;40(3):987-90. doi: 10.1161/STROKEAHA.108.524249. Epub 2009 Jan 22.

Reference Type BACKGROUND
PMID: 19164795 (View on PubMed)

Seidel G, Kaps M, Dorndorf W. Transcranial color-coded duplex sonography of intracerebral hematomas in adults. Stroke. 1993 Oct;24(10):1519-27. doi: 10.1161/01.str.24.10.1519.

Reference Type BACKGROUND
PMID: 8378956 (View on PubMed)

Ovesen C, Christensen AF, Krieger DW, Rosenbaum S, Havsteen I, Christensen H. Time course of early postadmission hematoma expansion in spontaneous intracerebral hemorrhage. Stroke. 2014 Apr;45(4):994-9. doi: 10.1161/STROKEAHA.113.003608. Epub 2014 Mar 13.

Reference Type DERIVED
PMID: 24627116 (View on PubMed)

Other Identifiers

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H-1-2011-069

Identifier Type: -

Identifier Source: org_study_id

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