Peripheral Leukocytes and Intracerebral Hemorrhage

About 70,000 people in the US die or suffer significant disability from spontaneous intracerebral hemorrhage (ICH) every year. No proven treatment is available that improves ICH outcomes. Since hematoma volume is the strongest predictor of ICH outcome, limiting hematoma expansion has been the primary goal of recent ICH clinical trials. Causes of secondary injury after the initial hemorrhage include hematoma expansion and cerebral edema. Identifying blood biomarkers associated with neurological deterioration and/or prognosis after ICH is a critical step for developing new therapies. Biomarkers that are mechanistically associated with hemostasis failure or cerebral edema would provide direction for exploring therapeutic targets, and identify patients in need of hemostatic or anti-inflammatory therapy.Peripheral white blood cell (WBC) count has been associated with hemorrhage volume and functional outcomes after ICH. However, it is unknown whether elevated WBCs represent an acute phase response or whether there is a pathophysiologic role of peripheral WBCs in ICH. Neutrophils and monocytes are predominant WBCs and peripheral neutrophil and monocyte infiltration have been found to contribute to secondary injury in animal models of ICH. Circulating monocytes particularly are well recognized to express significant amounts of tissue factor, interact with platelets, and modulate inflammation as well as thrombosis and hemostasis. We conducted the first human study to explore absolute monocyte counts in relation to ICH. We found that baseline peripheral monocyte count was independently associated with 30-day case-fatality in ICH patients who presented to the emergency department within 12 hours of symptom onset. Absolute monocyte count, a readily available and ubiquitous biomarker at presentation in ICH patients, may represent a novel prognostic tool after ICH.

Name thesis:degree_name

MS

Level thesis:degree_level

masters

Discipline thesis:degree_discipline

Medicine: Clinical and Translational Research

Grantor dc:publisher

University of Cincinnati

Year dc:date

2012

Author dc:creator

• Adeoye, Opeolu, M.D.

Contributors dc:contributor

• Haynes, Erin Nicole

• Surgery
• intracerebral hemorrhage
• inflammation
• leukocyte

Statement dc:rights

• unrestricted
• This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.

Language dc:language

English

Repository record dc:identifier

http://rave.ohiolink.edu/etdc/view?acc_num=ucin1353100438

OAI identifier oai:identifier

oai:etd.ohiolink.edu:ucin1353100438