Large Hematoma Research Articles

Conservative Management of a Large Bladder Flap Hematoma Post Cesarean Section: A Case Report and Mini Review of Literature

Conservative Management of a Large Bladder Flap Hematoma Post Cesarean Section: A Case Report and Mini Review of Literature

Middle meningeal artery embolization for the treatment of unilateral large chronic subdural hematoma patients with significant midline shift: A single-center experience.

The amount of midline shift (MLS) considered safe for middle meningeal artery embolization (MMAE) in patients with chronic subdural hematoma (CSDH) has not been established. Whether MMAE could be used as upfront treatment for unilateral large CSDH patients with significant MLS (>1 cm) has not been reported. To investigate the efficacy and safety of MMAE in unilateral large CSDH patients with MLS > 1 cm. Eleven carefully selected CSDH patients with mild or moderate symptoms and significant MLS > 1 cm from 1 May 2021 to 31 August 2022 were included in the study. All patients were treated with MMAE using polyvinyl alcohol (PVA) particles. Outcomes were assessed clinically and with interval imaging studies at follow-up. All 19 MMAs (unilateral embolization in three patients and bilateral embolization in eight patients) were successfully embolized. All 11 patients were followed for subsequent months, and there was no recurrence and enlargement of CSDH. Procedural adverse events, mortality, or complications were not observed. The average time to achieve a 50% reduction in MLS was approximately four weeks, while it took approximately eight weeks to achieve a 50% reduction in maximal volume. All 11 patients showed improvement in their neurological symptoms at three days post-operation, including four hemiplegic patients. MMAE may demonstrate safety in carefully selected CSDH patients with significant midline shift (MLS > 1 cm), particularly in those who are not suitable for surgery, thus providing a potential alternative approach.

Wunderlich syndrome as a rare complication of polyarteritis nodosa: a case report.

Spontaneous subcapsular and perirenal hemorrhage, known as Wunderlich syndrome (WS), is a rare clinical manifestation of polyarteritis nodosa (PAN). We report a case of a 48-year-old male with a history of recurrent episodes of leg muscle tenderness and dysesthesia, bilateral flank pain, painful nodular skin lesions in the lower limbs, weight loss, and difficult-to-control arterial hypertension. The abdominopelvic computed tomography angiography showed a large left perirenal hematoma, leading to the patient's admission to the intensive care unit. After the exclusion of infectious or neoplastic foci, the patient was diagnosed with PAN and started intravenous methylprednisolone pulses with a good response. Since WS is a rare initial clinical manifestation of PAN, an early diagnosis and aggressive treatment will significantly improve clinical outcomes.

Геморрагический инсульт: клинические проявления, исходы и факторы, модифицирующие течение заболеванияS

The article presents the causes, features of the clinical course and outcome of hemorrhagic strokes in 254 patients aged 40 to 92 years. Hemorrhagic strokes were often found in elderly and senile men (in the range from 60 to 89 years), with bad habits suffering from arterial hypertension in combination with obesity and diabetes, in the absence of adherence to the treatment of background pathology and the prevention of possible complications. A hemorrhagic stroke prevailed by the type of small hemata intracerebral hematomas. Risk factors for hemorrhagic strokes are clarified – arterial hypertension, dyslipidemia, obesity, diabetes, complications of which are strokes. The importance of the prevention of background diseases in patients frthom risk groups is confirmed. The total mortality in hemorrhagic stroke reached 49.61 %. In persons who received conservative treatment, mortality remained extremely high (88.32 %); It was caused by a special severity of patients and an unfavorable combination of risk factors. The lethal outcome were 1.86 times more in male patients than in female patients. Moreover, in cases of small and medium hematomas, death was often observed in male patients. The survival of patients with large intracerebral hematomas was minimal (1.89 %), wiout reliable gender differences. The clinical case of successful surgical treatment of a large intracerebral hematoma is given in the article.

Delayed Compartment syndrome after total knee replacement: A case report with short review

Purpose: We would like to report a case which developed delay anterior thigh compartment syndrome after total knee replacement surgery and review the underlying risk factors. Method: A 67years old lady was suffered from delay thigh anterior compartment syndrome 4 days after total knee replacement surgery. Urgent fasciotomy was performed. Later work up showed a large intramuscular haematoma within the anterior compartment which required drainage. Discussion: Short review was performed to identify the risk factors for developing compartment syndrome after total knee replacement surgery. Management strategy and prognosis was also discussed. Conclusion: Compartment syndrome should be diagnosed and treated promptly. Patient with underlying risk factors must be identified and with close monitoring of this rare complication in post-operative period.

Spontaneous large subperiosteal orbital hematoma in a patient with neuroblastoma

Abstract: We present a case of spontaneous large subperiosteal orbital hematoma in a 2-year-old boy causing compressive optic neuropathy. On physical examination, he was found to have an abdominal mass. The patient underwent urgent drainage of the subperiosteal orbital hematoma along with a biopsy of the abdominal mass which confirmed the diagnosis of neuroblastoma. Following surgery, proptosis, optic disc swelling, and afferent pupillary defect (APD) improved, and after one month of receiving two doses of chemotherapy, his general condition improved.

The effect of tracheotomy timing on short- term prognosis in hypertensive intracerebral haemorrhage patients after craniectomy: a retrospective analysis of early vs late intervention

Objective: The present study aimed to compare the clinical outcomes and short-term prognosis in patients with hypertensive intracerebral haemorrhage (HICH) with basal ganglia haematoma volume ≥ 60 mL who underwent early tracheotomy versus late tracheotomy post-craniectomy. Methods: A retrospective analysis was conducted based on the data of 102 patients with basal ganglia haematoma volume ≥ 60 mL after craniectomy between 2016 and 2021. Patients were divided into two groups: early tracheotomy and late tracheotomy. This study evaluated the effect of early tracheotomy on prognosis within 90 days and the impact of tracheotomy timing on overall survival in patients with HICH. Results: Patients in the early tracheotomy group showed a significant reduction in duration of ventilation and intracranial pressure (ICP) at 24 hours (post-tracheotomy) compared to those in the late tracheotomy group. Multivariable logistic regression indicated that late tracheotomy after craniectomy, old age, Glasgow Coma Scale (GCS) ≤ 6, large haematoma volume, and pneumonia after tracheotomy were risk factors for poor prognosis within 90 days in patients with HICH undergoing tracheotomy postoperatively. In terms of the impact of tracheotomy timing on overall survival in patients with HICH, 46 patients died within a follow-up period of 90 days; 19 in the early tracheotomy group (overall survival rate 62.7%), and 27 in the late tracheotomy group (overall survival of 47.1%). Conclusions: Early tracheotomy significantly improved the short-term prognosis of patients with HICH, with a higher overall survival rate compared to late tracheotomy within 90 days of illness.

Delayed Life-Threatening Hemorrhage Caused by Cranial Tibial Artery Pseudoaneurysm in Two Dogs.

Two adult dogs were presented at 25 and 30 days following tibial external skeletal fixator placement (case 1) and tibial plateau leveling osteotomy (case 2), respectively. Clinical signs at presentation for each of them included acute onset lethargy, non-weight-bearing lameness, and hemorrhage at the surgical site with large hematoma formation. On admission, emergency whole blood transfusion was required in case 2 with a preoperative packed cell volume of 13%. Both dogs were diagnosed with pseudoaneurysm of the cranial tibial artery based on color Doppler ultrasonography. Additionally, computed tomography angiography was performed in one dog. Surgical treatment of the dogs included ligation of the cranial tibial artery supplying the pseudoaneurysm and curettage of hematoma. The surgery was completed without complications in case 1, but case 2 experienced inadvertent rupture of pseudoaneurysm with significant blood loss, which required another whole blood transfusion during the procedure. Both dogs had excellent functional recovery with no recurrence of clinical signs. We hypothesized that pseudoaneurysms were primarily caused by trauma secondary to placement of surgical implants or osteotomy. For orthopedic surgeons, it is important to recognize clinical signs of a potential tibial arterial pseudoaneurysm, as early surgical intervention may prevent loss of limb or life.

Pediatric scurvy case report: a novel presentation with deep vein thrombosis secondary to large bilateral spontaneous iliac subperiosteal hematomas

BackgroundScurvy is an uncommon disease in developed countries caused by deficiency of vitamin C. We present a case of scurvy in a 14-year-old male with autism with both novel presentation and imaging findings. This case had the novel presentation of lower limb deep vein thrombosis (DVT) secondary to compression of the external iliac vein from large bilateral iliac wing subperiosteal hematomas. Subperiosteal hematoma is a well-recognised feature of scurvy but large and bilateral pelvic subperiosteal hematoma causing DVT has not previously been described.Case presentationA 14 year old Caucasian male with background of autism and severe dietary restriction presented with lower limb swelling and immobility. He was diagnosed with lower limb DVT. Further investigation revealed an iron deficiency anaemia, and he was found on MRI to have large bilateral subperiosteal iliac hematomata causing compression of the iliac vessels. He improved following treatment with vitamin C replacement and follow-up imaging demonstrated resolution of the DVT and hematoma.ConclusionDVT is rare in children and when diagnosed should prompt investigation as to the underlying cause. This case demonstrates an unusual cause of DVT and as an unusual presentation of paediatric scurvy.

Prothrombin Complex Concentrate vs Conservative Management in ICH Associated With Direct Oral Anticoagulants.

Intracerebral hemorrhage (ICH) associated with direct oral anticoagulant (DOAC) use carries extremely high morbidity and mortality. The clinical effectiveness of hemostatic therapy is unclear. To compare the clinical and radiological outcomes of DOAC-associated ICH treated with prothrombin complex concentrate (PCC) vs conservative management. In this population-based, propensity score-weighted retrospective cohort study, patients who developed DOAC-associated ICH from January 1, 2016, to December 31, 2021, in Hong Kong were identified. The outcomes of patients who received 25 to 50 IU/kg PCC with those who received no hemostatic agents were compared. Data were analyzed from May 1, 2022, to June 30, 2023. The primary outcome was modified Rankin scale of 0 to 3 or returning to baseline functional status at 3 months. Secondary outcomes were mortality at 90 days, in-hospital mortality, and hematoma expansion. Weighted logistic regression was performed to evaluate the association of PCC with study outcomes. In unweighted logistic regression models, factors associated with good neurological outcome and hematoma expansion in DOAC-associated ICH were identified. A total of 232 patients with DOAC-associated ICH, with a mean (SD) age of 77.2 (9.3) years and 101 (44%) female patients, were included. Among these, 116 (50%) received conservative treatment and 102 (44%) received PCC. Overall, 74 patients (31%) patients had good neurological recovery and 92 (39%) died within 90 days. Median (IQR) baseline hematoma volume was 21.7 mL (3.6-66.1 mL). Compared with conservative management, PCC was not associated with improved neurological recovery (adjusted odds ratio [aOR], 0.62; 95% CI, 0.33-1.16; P = .14), mortality at 90 days (aOR, 1.03; 95% CI, 0.70-1.53; P = .88), in-hospital mortality (aOR, 1.11; 95% CI, 0.69-1.79; P = .66), or reduced hematoma expansion (aOR, 0.94; 95% CI, 0.38-2.31; P = .90). Higher baseline hematoma volume, lower Glasgow coma scale, and intraventricular hemorrhage were associated with lower odds of good neurological outcome but not hematoma expansion. In this cohort study, Chinese patients with DOAC-associated ICH had large baseline hematoma volumes and high rates of mortality and functional disability. PCC treatment was not associated with improved functional outcome, hematoma expansion, or mortality. Further studies on novel hemostatic agents as well as neurosurgical and adjunctive medical therapies are needed to identify the best management algorithm for DOAC-associated ICH.

Which elements of hospital-based clinical decision support tools for the assessment and management of children with head injury can be adapted for use by paramedics in prehospital care? A systematic mapping review and narrative synthesis

ObjectiveHospital-based clinical decision tools support clinician decision-making when a child presents to the emergency department with a head injury, particularly regarding CT scanning. However, there is no decision tool to...

A case report of spontaneous superficial temporal artery hemorrhage following COVID-19 infection

Post-COVID syndrome and COVID-19 have been related to autonomic changes and the appearance of endothelial dysfunction. Current research has discovered vasculitis-like occurrences in patients previously without evidence of endothelial dysfunction or autoimmune states. Additionally, COVID-19 and post-COVID syndrome have been hypothesized to induce flares of vascular dysfunction. Here, we present a patient with a large hematoma of the right scalp following spontaneous superficial temporal artery hemorrhage after uncontrolled hypertension, tachycardia, and generalized weakness three months after COVID-19 infection. This patient’s bleed was successfully managed with a pressure bandage and did not require neurosurgical embolization; moreover, he had no prior hemorrhages or indications for vessel rupture. Our case study represents a patient with chronic changes in blood pressure and heart rate following a prior COVID-19 infection that led to a large superficial scalp hematoma over the right frontotemporal bone with active extravasation from the right superficial temporal artery.

A large post-stenting intramural hematoma in the left anterior descending artery caused by a small intimal calcium spur; should we respect the calcium shape?

Coronary heavy calcification (HC) poses a sturdy challenge to percutaneous coronary intervention (PCI). Scores considering calcification length, thickness, or circumferential extent, are widely accepted to dictate upfront calcium modification to improve PCI outcomes. Although often marginalized, calcification shape (morphology) may require consideration during procedure planning in selected cases. This case demonstrates how a focal but spur-shaped calcification led to a massive proximal left anterior descending (LAD) dissecting intramural hematoma.

The 2022 Crimean-Congo Hemorrhagic Fever outbreak in Iraq

Crimean-Congo Hemorrhagic fever (CCHF) is an endemic, zoonotic, viral, and tick-borne disease that causes hemorrhagic symptoms. The disease has been reported in Iraq since 1979 comprising six cases between 1989 and 2009. Subsequently, 11, 3, and 33 cases were reported in 2010, 2018, and 2021, respectively. This study describes the 2022 Crimean-Congo Hemorrhagic fever virus (CCHFV) outbreak in different Iraqi governorates. In the 2022 outbreak, 212 cases of human CCHFV were reported between January 1 and May 22. These included 97 (46%) cases confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) and 115 (54%) suspected cases. Most human cases have been reported for livestock breeders and butchers. Approximately half of the confirmed cases (48%) were reported in the Dhi Qar governorate, whereas the others were reported in Missan, Muthanna, Wasit, Diwaniya, Karkh/Baghdad, Rusafa/Baghdad, Kirkuk, Basra, Najaf, Nineveh, Babylon, and Karbala. Patients with CCHFV showed symptoms of the pre-hemorrhagic phase, including sudden fever, anorexia, vomiting, diarrhea, headache, nose bleeding, and abdominal and joint pain. Later, hemorrhagic symptoms started with unexplained bleeding lesions, ranging from small petechiae to large hematomas. The factors responsible for the re-emergence of CCHFV included a shortage of veterinary services during the COVID-19 pandemic and illegal slaughtering of animals outside the abattoirs. This led to massive tick infestations that acted as viral vectors. In conclusion, this is the first report documenting the 2022 CCHFV outbreak in Iraq, with a total of 212 patients and 27 overall deaths, including 13 laboratory-confirmed cases. The authors recommend improving veterinary services provided to farmers. Additionally, future studies need to be done including the sero-epidemiology and molecular studies on local livestock and ticks to understand their roles in circulating the virus to humans.

Chitosan‐Based Hemostatic Pad Reduced Vascular Complications After Transradial Coronary Intervention in Uncontrolled Hypertensive Patients: Application of Chitosan‐Based Hemostatic Pad on CAG or PCI

Background: Vascular complications after coronary angiography (CAG) or percutaneous coronary intervention (PCI) are a major concern for revascularization therapies. In this study, we investigated whether the application of a chitosan‐based hemostatic pad (HP) could ameliorate vascular complications after CAG or PCI procedures.Methods: We retrospectively analyzed patients undergoing CAG or PCI in our cardiovascular center from January 2019 to December 2021. The incidence of total vascular complications including errhysis, large hematoma, pseudoaneurysm, radial artery occlusion (RAO), blister, and pain was recorded. Subgroup analyses of patients with a history of hypertension, patients with uncontrolled hypertension, and patients with controlled hypertension were performed.Results: Our results demonstrated that the application of chitosan‐based HP had no effect on vascular complications after CAG or PCI procedures (odds ratio [OR]: 1.03 (0.84–1.26), p = 0.80). Nevertheless, chitosan‐based HP treatment markedly decreased the incidence of vascular complications in uncontrolled hypertensive patients (OR: 0.32 (0.11–0.95), p = 0.04), but not in hypertensive patients with controlled blood pressure (BP) (OR: 1.09 (0.88–1.35), p = 0.42).Conclusions: Chitosan‐based HP treatment could reduce the incidence of vascular complications in patients with uncontrolled hypertension. Nonetheless, applying chitosan‐based HP treatment after CAG or PCI procedures is not recommendable for controlled hypertensive patients.

Compressive Intrapericardial Hematoma Following Thoracotomy to Seal Coronary Artery Perforation

Abstract A 68-year-old male developed cardiac tamponade secondary to coronary artery perforation following percutaneous coronary artery intervention. He underwent thoracotomy to seal the perforation of the acute marginal branch of the right coronary artery. Following sealing of perforation with application of cyanoacrylate to the right atrioventricular groove, the patient remained stable with minimal pericardial effusion for 1 month and later developed a large (6 cm × 5 cm) intrapericardial hematoma compressing the right ventricular inflow with intermittent fever. The patient declined repeat surgery and showed some regression of hematoma and a decrease in trans-tricuspid pressure gradients with colchicine after 1 month. The case is reported for its rarity with a review of literature.

Acquired Hemophilia A Diagnosed Based on Gross Hematuria: A Case Report and Literature Review

Acquired hemophilia A (AHA) is an acquired bleeding disorder caused by neutralizing antibodies (inhibitors) against Coagulation Factor VIII (FVIII:C), causing sudden hemorrhagic symptoms (i.e., subcutaneous bleeding, intramuscular bleeding, and hematuria). Herein, this study is aimed at presenting a case of AHA diagnosed based on hematuria and reviewing patients who were diagnosed with AHA due to hematuria. A 67‐year‐old woman was referred to Atsugi City Hospital with painless gross hematuria that began 4 weeks before presentation. Contrast‐enhanced computed tomography (eCT) revealed an approximately 2 cm mass in the right renal pelvis, and the patient’s activated partial thromboplastin time (APTT) was elevated (61.4 s). The day after the endoscopic biopsy, the patient was in shock due to a large retroperitoneal hematoma. Although her condition stabilized after intravenous radioembolization, she underwent emergency surgeries several times because of rebleeding within the next 3 weeks. At that time, APTT was more prolonged at 106.4 s, and the FVIII:C level was 2%. Mixing tests showed an upwardly convex curve after 2‐h incubation, indicating the presence of an inhibitor. Factor VIII inhibitor titer was ≥5.1 Bethesda unit (BU)/mL. A combined product of Plasma‐Derived Factors VIIa and X (pd‐FVIIa/FX), as second‐line hemostatic therapy, as well as cyclophosphamide (CYP), were administered after Recombinant Activated Factor VIIa (rFVIIa) had been ineffective. Following this, the Factor VIII inhibitor titer was undetectable, FVIII:C levels were restored, and APTT decreased to within the normal range. Gross hematuria was significantly alleviated. However, the patient died of cytomegalovirus and fungal infections due to prolonged immunosuppressive therapy. Although AHA diagnosed based on hematuria may have a better prognosis than others, there have been occasional cases with severe outcomes. APTT, detected upon initial hematological testing in patients with hematuria, may be a potential indicator of an existing AHA.

Abstract B030: Intracerebral and intraventricular hemorrhage due to severe thrombocytopenia: A rare case of Evans syndrome

Abstract Introduction: Evans syndrome (ES) is a rare autoimmune disorder characterized by the development of autoimmune hemolytic anemia (AIHA), immune thrombocytopenia (ITP), and/or immune neutropenia (AIN) without an identifiable cause. It is believed to involve immune system dysregulation, leading to the destruction of red blood cells, platelets, and neutrophils. Case Presentation: A 68-year-old male with a history of coronary artery disease, hypertension, diabetes, and atrial fibrillation presented with abdominal pain and diarrhea. Laboratory tests revealed a platelet count of 3k, suggesting ITP. Initial treatment with dexamethasone and platelet transfusion provided limited improvement. A bone marrow biopsy showed mildly hypercellular bone marrow with trilineage hematopoiesis. However, the patient's condition rapidly deteriorated, and he returned to the emergency department with severe symptoms, including headache, gum bleeding, and lower extremity petechiae. A CT scan revealed a large intraparenchymal hematoma with intraventricular hemorrhage, highlighting the risk of life-threatening bleeding in ES patients. Discussion: The patient was managed with platelet transfusions, high-dose steroids, and intravenous immunoglobulin (IVIG), which provided temporary relief but failed to maintain stable platelet levels. Further investigations revealed a positive antinuclear antibody (ANA), suggesting an underlying rheumatological condition and confirming the diagnosis of secondary ES. This finding necessitated the exploration of treatment options. Of interest is Romiplostim (Promacta), a thrombopoietin receptor agonist, which has shown promise in increasing platelet counts and reducing bleeding episodes in refractory ITP. Considering the positive ANA and the suspected rheumatological etiology, Romiplostim may serve as a viable long-term treatment option to stabilize platelet levels and mitigate bleeding risks in this case. Conclusion: This case highlights the complexity of Evans syndrome and emphasizes the need to promptly recognize and manage life-threatening bleeding complications, particularly in older patients. The presence of a positive ANA suggests an underlying rheumatological condition, necessitating comprehensive evaluation, and tailored therapeutic approaches. Although further research is needed to understand the pathogenesis and optimal management strategies for ES, Romiplostim holds promise as a potential treatment for patients with secondary ES who are unresponsive to conventional therapies. Citation Format: Kiersten R. Patterson, Aliya M. Khan, Raj Patel. Intracerebral and intraventricular hemorrhage due to severe thrombocytopenia: A rare case of Evans syndrome [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B030.

Exogenous Peptide Injection Causing Medical Thigh Compartment Syndrome

BackgroundAcute compartment syndrome can be caused by any condition that increases the pressure of an intracompartmental muscular space, resulting in ischemia, which is a limb-threatening emergency. This case report is the first known documented example of an exogenously injected peptide causing compartment syndrome. The use of natural supplements and holistic therapies is on the rise, specifically, peptide injections. It is important to obtain the history of use and routes of administration of these substances. Case ReportWe present a case of a 43-year-old man who presented to the Emergency Department with worsening thigh pain. The patient had injected a “peptide cocktail” into his thigh 3 days prior. Physical examination revealed trace pitting edema of the left leg with moderate muscle spasm and tenderness of the medial aspect of the distal thigh with associated numbness along the medial aspect of the knee. Point-of-care ultrasound detected intramuscular edema and free fluid in the leg. He was found to have acute compartment syndrome of the thigh secondary to the peptide cocktail injection, causing a large hematoma posterior to the adductor magnus. The patient required fasciotomy and hematoma evacuation. He ultimately left against medical advice during his hospitalization. Why Should an Emergency Physician Be Aware of This?In an age when many patients look for supplements to aid with weight loss and muscle growth, it is essential to be aware of peptide injection therapies and the potential complication of compartment syndrome.

Intracerebral Hemorrhage Leads to Anemia By Disrupting Erythropoiesis and Erythromyeloblastic Islands

Intracerebral hemorrhage (ICH), caused by the rupture of a cerebral vessel and subsequent entry of blood into the brain parenchyma, is a major form of acquired brain injury and contributes a remarkable proportion of stroke-related morbidity and mortality. Due to the few proven effective emergency and preventive treatments, patients who survived suffer varying degrees of poor prognosis that affect their quality of life. There is an urgent need to explore the cellular and molecular basis of the differences in the severity and prognosis of ICH. Anemia is a common manifestation of ICH. However, the mechanisms underlying ICH-induced anemia as we as the correlation between anemia and ICH progression/prognosis remain unclear. In this study, we found that approximately 35.1% (39 of 111) of ICH patients exhibited anemia and that decreased hemoglobin levels were positively associated with higher scores on the National Institutes of Health Stroke Scale, which quantifies the degree of neurological deficit, at admission. Furthermore, patients with decreased hemoglobin levels at admission showed higher modified Rankin scale scores at 3 months, which reflect the global disability of daily living at this time, suggesting that anemia was associated with a more severe progression and poor patient prognosis. To investigate the effects of ICH on bone marrow (BM) erythropoiesis, we conducted experiments in 12-month-old mice with collagenase-induced striatal ICH. Our results showed that ICH caused apparent anemia on day 3, associated with larger hematomas in the striatum and more severe neurologic deficits. We first evaluated the phenotype of hematopoietic progenitors and found that mice suffering ICH exhibited increased granulocyte monocyte progenitors but a significant decrease in common myeloid progenitors and megakaryocyte erythrocyte progenitors compared to control mice, suggesting a reduced source of erythroid progenitors. Further analysis revealed that the colony-forming ability of erythroid progenitors and subsequent terminal differentiation was significantly suppressed after ICH. To assess whether ICH-induced suppression of erythropoiesis is associated with erythromyeloblastic islands (EMBIs), the niche for erythropoiesis/myelopoiesis, we performed ICH using 12-month-old EpoR-tdTomato-Cre mice and found that the number of BM EMBIs and EpoR + macrophages decreased significantly. Moreover, the number and proportion of developing erythroid cells surrounding EMBIs decreased while LY6G + cells representing granulocytes increased prominently, indicating an altered microenvironment, with EMBI favoring granulopoiesis over erythropoiesis after ICH. Studies have shown that inflammation plays a crucial role in secondary brain injury after ICH. We hypothesize that inflammatory cytokines may contribute to the suppression of erythropoiesis observed in ICH mouse models. To test this, we measured inflammatory factors in both peripheral blood and BM fluid using Quantibody Mouse Inflammation Array. In particular, IL-6 concentrations in peripheral blood and BM fluid in ICH mice were significantly higher than controls. Treatment with MR16-1, an IL-6 antagonist, alleviated ICH-induced anemia and improved BM erythropoiesis in ICH mice, as evidenced by increased peripheral red blood cells and hemoglobin levels, elevated numbers of erythroid progenitors and terminal erythroblast. MR16-1 treatment also improved BM EMBI formation and increased EpoR + macrophages. In addition, MR16-1 treatment effectively improved neurologic deficits and reduced brain hematoma after ICH. Administration of recombinant IL-6 to wild-type mice resulted in decreased levels of red blood cells and hemoglobin along with suppression of erythropoiesis in the BM. Collectively, these results suggest that ICH modulates erythropoiesis and erythromyeloblastic islands function to ultimately lead to anemia and reveal a possible therapeutic opportunity to reverse ICH-induced anemia and improve ICH prognosis by targeting IL-6.