Abstract 2653: Hypothermia For Intracerebral Hemorrhage: Mortality And Long-term Functional Outcome

Abstract

Background Mild prolonged hypothermia reduces perihemorrhagic edema (PHE) growth and may improve survival after large intracerebral hemorrhage (ICH). However, functional outcome data are scarce and lower mortality after large ICH may be achieved at the cost of higher disability. We investigated the course of edema evolution and long term functional outcome in 22 consecutive patients with large ICH (>25ml) who were treated with hypothermia. Methods Mild endovascular hypothermia (35°C) was applied within 12h after symptom onset for a period of 10 days. PHE was measured on computed tomography scans using a semi-automatic threshold based algorithm. Outcome was assessed 90 days and one year after symptom onset. Results Twenty-two patients aged 62±9 years with spontaneous supratentorial ICH (58±25ml) received hypothermia. Volumetric analysis showed significantly less PHE in those patients during and after hypothermia, as compared to historical controls who did not receive hypothermia. Twenty patients (91%) survived until day 90 after symptom onset. One year after the bleeding event, eight patients had a modified Rankin scale (mRS) score of 3, eight patients had a mRS of 4, two patients a mRS of 5 and totally four patients had died. Conclusions Despite of large initial ICH size, patients treated with hypothermia showed a low mortality rate and eight patients (36%) were able to walk without assistance one year after ICH. Hypothermia may be a promising treatment approach in large ICH. An ongoing multicenter randomized clinical trial (CINCH) is investigating this treatment option.