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Related Concept Videos

Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

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The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
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Leveraging Turbidity and Thromboelastography for Complementary Clot Characterization
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Coagulation Differences Detectable in Deep and Lobar Primary Intracerebral Hemorrhage Using Thromboelastography.

David Roh1, Glenda L Torres2, Chunyan Cai3

  • 1Department of Neurology, Columbia University, New York, New York.

Neurosurgery
|March 14, 2020
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Summary

Deep intracerebral hemorrhage (ICH) patients show longer clot formation times compared to lobar ICH, suggesting relative coagulopathy. This finding confirms prior work on coagulation differences in ICH locations.

Keywords:
DeepFunctional coagulationIntracerebral hemorrhageLobarThromboelastography

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Area of Science:

  • Neurology
  • Hematology
  • Medical Diagnostics

Background:

  • Intracerebral hemorrhage (ICH) presents with distinct radiographic and clinical outcomes based on location (deep vs. lobar).
  • Pilot studies indicate potential functional coagulation differences between deep and lobar ICH, detectable via whole blood coagulation testing.

Purpose of the Study:

  • To validate functional coagulation differences between deep and lobar ICH using thromboelastography (TEG) in a larger patient cohort.
  • To investigate interlocation coagulation variations in primary ICH patients.

Main Methods:

  • Prospective data collection from 2009-2018 for primary ICH patients at a tertiary referral center.
  • Analysis of deep and lobar ICH patients who underwent admission TEG, excluding those with prior anticoagulant use or coagulopathy.
  • Linear regression models adjusted for hematoma size, age, sex, and stroke severity to assess ICH location's association with TEG and plasma coagulation tests.

Main Results:

  • 154 deep ICH and 53 lobar ICH patients were analyzed; deep ICH patients were younger with smaller hematoma volumes.
  • Adjusted analysis revealed significantly longer TEG R times (indicating slower clot formation) in deep ICH compared to lobar ICH (P=0.04).
  • No significant differences were observed in other TEG parameters or plasma-based coagulation tests between the groups.

Conclusions:

  • Longer clot formation times in deep ICH suggest relative coagulopathy compared to lobar ICH, corroborating previous findings.
  • Further research is needed to understand the mechanisms behind these coagulation differences.
  • The findings may inform future treatment strategies for coagulopathy in ICH patients based on lesion location.