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Apolipoprotein E modifies neurological outcome by affecting cerebral edema but not hematoma size after intracerebral hemorrhage in humans.

Publication ,  Journal Article
James, ML; Blessing, R; Bennett, E; Laskowitz, DT
Published in: J Stroke Cerebrovasc Dis
2009

INTRODUCTION: To address the mechanisms by which apoE polymorphism affects functional outcome after intracerebral hemorrhage in humans, we tested the hypothesis that the presence of the APOE4 allele results in amplified inflammatory responses and increased cerebral edema. METHODS: We prospectively enrolled and collected data on 21 adult patients consecutively admitted to Duke University Hospital with supratentorial intracerebral hematoma including hemorrhage volume, midline shift, modified Rankin Score, Glasgow Outcome Score, and APOE genotype. Hemorrhage size (cm(3)) and midline shift (mm), at the level of the thalamus, were measured by computed tomography within 36 hours of admission. Rankin and Glasgow Scores were determined at discharge. Student's t-test was used to analyze hemorrhage size, midline shift, and Glasgow Outcome Score and logistical regression were used to measure allele affect on modified Rankin Score. When analyzing modified Rankin Score, patients were grouped by favorable outcome (0-2) or unfavorable (3-6). RESULTS: Out of 21 patients, 11 possessed at least 1 APOE4 allele (APOE4+). There was no difference in hemorrhage volume (25.8 v 38.3 mm for APOE4- v APOE4+, respectively) between the groups, but there was a significant difference in midline shift (P = .04, 0.7 v 4 mm). Functional outcomes were worse for the patients possessing at least 1 APOE4 allele (P = .04) CONCLUSION: The presence of APOE4 is associated with poor functional outcomes in humans after intracerebral hemorrhage. Our data suggest that the mechanism for this may be increased cerebral edema and not larger hematoma volume.

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Published In

J Stroke Cerebrovasc Dis

DOI

EISSN

1532-8511

Publication Date

2009

Volume

18

Issue

2

Start / End Page

144 / 149

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Severity of Illness Index
  • Prognosis
  • Polymorphism, Genetic
  • Outcome Assessment, Health Care
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Genotype
 

Citation

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ICMJE
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James, M. L., Blessing, R., Bennett, E., & Laskowitz, D. T. (2009). Apolipoprotein E modifies neurological outcome by affecting cerebral edema but not hematoma size after intracerebral hemorrhage in humans. J Stroke Cerebrovasc Dis, 18(2), 144–149. https://doi.org/10.1016/j.jstrokecerebrovasdis.2008.09.012
James, Michael L., Robert Blessing, Ellen Bennett, and Daniel T. Laskowitz. “Apolipoprotein E modifies neurological outcome by affecting cerebral edema but not hematoma size after intracerebral hemorrhage in humans.J Stroke Cerebrovasc Dis 18, no. 2 (2009): 144–49. https://doi.org/10.1016/j.jstrokecerebrovasdis.2008.09.012.
James ML, Blessing R, Bennett E, Laskowitz DT. Apolipoprotein E modifies neurological outcome by affecting cerebral edema but not hematoma size after intracerebral hemorrhage in humans. J Stroke Cerebrovasc Dis. 2009;18(2):144–9.
James, Michael L., et al. “Apolipoprotein E modifies neurological outcome by affecting cerebral edema but not hematoma size after intracerebral hemorrhage in humans.J Stroke Cerebrovasc Dis, vol. 18, no. 2, 2009, pp. 144–49. Pubmed, doi:10.1016/j.jstrokecerebrovasdis.2008.09.012.
James ML, Blessing R, Bennett E, Laskowitz DT. Apolipoprotein E modifies neurological outcome by affecting cerebral edema but not hematoma size after intracerebral hemorrhage in humans. J Stroke Cerebrovasc Dis. 2009;18(2):144–149.
Journal cover image

Published In

J Stroke Cerebrovasc Dis

DOI

EISSN

1532-8511

Publication Date

2009

Volume

18

Issue

2

Start / End Page

144 / 149

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Severity of Illness Index
  • Prognosis
  • Polymorphism, Genetic
  • Outcome Assessment, Health Care
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Humans
  • Genotype