Evidence map›Paper›PMID 40109238›Full record

ArticleStroke2025

Volume Tolerance and Prognostic Impact of Hematoma Expansion in Deep and Lobar Intracerebral Hemorrhage.

Andrea Morotti, Qi Li, Jawed Nawabi, Federico Mazzacane, Frieder Schlunk, Ashkan Shoamanesh, Giorgio Busto, Anna Cavallini, Francesco Palmerini, Maurizio Paciaroni and 12 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

22 authors.

Andrea MorottiDepartment of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Italy (A.M., A.P.).ORCID 0000-0002-6558-1155
Qi LiDepartment of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China (Q.L.).ORCID 0000-0002-9144-148X
Jawed NawabiBerlin Institute of Health (BIH), BIH Biomedical Innovation Academy, Germany (J.N.).ORCID 0000-0002-1137-0643
Federico MazzacaneU.C. Malattie Cerebrovascolari e Stroke Unit, IRCCS Fondazione Mondino, Pavia, Italia (F.M., A.C.).ORCID 0000-0002-2224-8002
Frieder SchlunkDepartment of Neuroradiology, Medical Centre, University of Freiburg, Germany (F.S.).
Ashkan ShoamaneshDivision of Neurology, Department of Medicine, McMaster University/Population Health Research Institute, Hamilton, ON, Canada (A.S.).ORCID 0000-0002-2802-1626
Giorgio BustoDepartment of Biomedical Experimental and Clinical Neuroradiology, University of Firenze, AOU Careggi, Italy (G.B., E.F.).
Anna CavalliniU.C. Malattie Cerebrovascolari e Stroke Unit, IRCCS Fondazione Mondino, Pavia, Italia (F.M., A.C.).ORCID 0000-0002-5227-1502
Francesco PalmeriniUnit of Neurology, Fondazione Poliambulanza, Brescia, Italy (F.P.).
Maurizio PaciaroniDepartment of Neurosciences and Rehabilitation, Azienda Ospedaliero-Universitaria di Ferrara, Arcispedale Sant'Anna - Cona, University of Ferrara, Italy (M.P.).ORCID 0000-0002-5483-8795
Edip M GurolJ. P. Kistler Stroke Research Center, Harvard Medical School (E.M.G., A.V., S.M.G., J.R., J.N.G.), Massachusetts General Hospital, Boston.ORCID 0000-0002-2169-4457
Anand ViswanathanJ. P. Kistler Stroke Research Center, Harvard Medical School (E.M.G., A.V., S.M.G., J.R., J.N.G.), Massachusetts General Hospital, Boston.ORCID 0000-0001-5398-1816
Ilaria CasettaIRCCS San Camillo Hospital, Venice, Italy (I.C.).ORCID 0000-0003-4099-8875
Laura PiccoloIRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neurologia e Rete Stroke Metropolitana, Ospedale Maggiore, Italy (L.P., A.Z.).ORCID 0000-0002-4641-8352
Enrico FainardiDepartment of Biomedical Experimental and Clinical Neuroradiology, University of Firenze, AOU Careggi, Italy (G.B., E.F.).ORCID 0000-0003-0477-724X
Steven M GreenbergJ. P. Kistler Stroke Research Center, Harvard Medical School (E.M.G., A.V., S.M.G., J.R., J.N.G.), Massachusetts General Hospital, Boston.ORCID 0000-0003-1792-8887
Alessandro PadovaniDepartment of Clinical and Experimental Sciences, Neurology Unit, University of Brescia, Italy (A.M., A.P.).
Andrea ZiniIRCCS Istituto delle Scienze Neurologiche di Bologna, UOC Neurologia e Rete Stroke Metropolitana, Ospedale Maggiore, Italy (L.P., A.Z.).ORCID 0000-0003-1486-4507
Jonathan RosandJ. P. Kistler Stroke Research Center, Harvard Medical School (E.M.G., A.V., S.M.G., J.R., J.N.G.), Massachusetts General Hospital, Boston.ORCID 0000-0002-1014-9138
Joseph P BroderickDepartment of Neurology and Rehabilitation Medicine, University of Cincinnati, OH (J.P.B.).ORCID 0000-0002-7323-7709
Dar DowlatshahiDepartment of Medicine (Neurology), University of Ottawa and Ottawa Hospital Research Institute, ON, Canada (D.D.).ORCID 0000-0003-1379-3612
Joshua N GoldsteinJ. P. Kistler Stroke Research Center, Harvard Medical School (E.M.G., A.V., S.M.G., J.R., J.N.G.), Massachusetts General Hospital, Boston.ORCID 0000-0002-6406-1828

Funding

American Heart Association-American Stroke Association 812095
6 · The paper itself

Abstract

backgroundThe prognostic impact of intracerebral hemorrhage (ICH) volume varies according to location, with smaller volume tolerance in deep ICH, and hematoma expansion (HE) contributes to final ICH volume. We tested the hypothesis that HE influences outcome only when the final ICH volume achieves a critical threshold that differs according to ICH location.

methodsRetrospective analysis of patients with supratentorial ICH admitted at 10 centers in North America and China (development cohort) and Europe (replication cohort). HE was defined as growth >33% and/or >6 mL. Location-specific (lobar versus deep) volume cutoffs for the prediction of poor outcomes were derived using receiver operating characteristic curves and the Youden index. The prognostic impact of HE stratified by location and final volume was explored with logistic regression (poor outcome: 90-day modified Rankin Scale score of 4-6), accounting for age, Glasgow Coma Scale, baseline volume, intraventricular hemorrhage, and admission center.

resultsWe identified 1774 patients with ICH in the development cohort and 1746 in the replication cohort. A total of 1058 (mean age, 68 years; 47.8% men) and 1423 (mean age, 71 years; 44.7% men) subjects met the inclusion criteria, respectively. The optimal final ICH volume cutoff for poor outcome differed by location: ≥36 mL for lobar and ≥17 mL for deep ICH. HE with final volume below the cutoff was not associated with higher odds of poor outcome compared with patients without HE (adjusted odds ratio, 1.85 [95% CI, 0.78-4.38];

conclusionsHE significantly impacts severe outcomes only when the final ICH volume exceeds a critical target threshold, and this threshold is lower in deep versus lobar ICH. These findings might inform clinical practice and future trials.

Indexed as

Cerebral HemorrhageHematomaAgedAged, 80 and overCohort StudiesEuropeFemaleHumansMaleMiddle AgedPrognosisRetrospective Studiescerebral hemorrhagehematomamorbidityprognosisstroke

Identifiers

PMID40109238
PMCPMC12037302

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.