Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, United Kingdom (L.L.).
Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute and Department of Neurology, Weill Cornell Medicine, NY (S.B.M.).
Stroke. 2022 Jul;53(7):2131-2141. doi: 10.1161/STROKEAHA.122.036884. Epub 2022 Jun 8.
Cardiovascular events after primary intracerebral hemorrhage (ICH) have emerged as a leading cause of poor functional outcomes and mortality during the long-term recovery after an ICH. These events encompass arterial ischemic events such as ischemic stroke and myocardial infarction, arterial hemorrhagic events that include recurrent ICH, and venous thrombotic events such as venous thromboembolism. The purpose of this review is to summarize the cardiovascular complications after ICH, epidemiology and associated risk factors, and their impact on ICH outcomes. Additionally, we will highlight possible pathophysiological mechanisms to explain the short- and long-term increased risks of ischemic and hemorrhagic events after ICH. Finally, we will highlight potential secondary stroke and venous thrombotic prevention strategies often not considered after ICH, balanced against the risk of ICH recurrence.
原发性脑出血(ICH)后发生的心血管事件已成为ICH 后长期恢复期间功能结局不良和死亡率升高的主要原因。这些事件包括动脉缺血性事件,如缺血性卒中和心肌梗死,动脉出血性事件,包括复发性 ICH,以及静脉血栓栓塞性事件,如静脉血栓栓塞。本文旨在总结 ICH 后的心血管并发症、流行病学和相关危险因素及其对 ICH 结局的影响。此外,我们还将强调可能的病理生理机制,以解释 ICH 后缺血性和出血性事件短期和长期风险增加的原因。最后,我们将强调ICH 后通常不考虑的潜在二级卒中预防和静脉血栓形成策略,以及与ICH 复发风险的平衡。