Prognostic Role of Perihematomal Edema in Intracerebral Hemorrhage: A Systematic Review

Abstract

Although several studies have suggested perihematomal edema (PHE) is associated with prognosis in intracerebral hemorrhage(ICH), the results are different in other studies. The purpose of this study was to evaluate the prognostic role of PHE in ICH.According to PRISMA guidelines, a systematic literature search of PubMed, EMBASE, SCOPUS, Web of Science and CochraneLibrary was performed. Published clinical studies reporting association between PHE and prognosis in ICH were included. Datawere extracted including sample size, patient characteristics, PHE measures, outcome measures and follow-up. A total of 21studies were included with 6 prospective studies and 15 retrospective studies. PHE measures included perihematomal edemaabsolute volume (PHEAV), relative perihematomal edema volume (rPHE), perihematomal edema absolute volume growth (PHEAVgrowth), perihematomal edema expansion rate (PHEER), relative perihematomal edema growth (relative PHE growth), cytotoxicedema (CE) and perihematomal edema absolute area (PHEAA). The association of PHEAV/ rPHE /PHEAV growth and outcome areconflicting in different studies. Meta-analysis showed PHEER at 72 hours was significantly associated with poor clinical outcome at90 days (OR=1.54, 95%CI 1.04-2.22, p