Triggering factors in non-traumatic intracerebral hemorrhage

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Sallinen , H , Putaala , J & Strbian , D 2020 , ' Triggering factors in non-traumatic intracerebral hemorrhage ' , Journal of Stroke & Cerebrovascular Diseases , vol. 29 , no. 8 , 104921 . https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104921

Title: Triggering factors in non-traumatic intracerebral hemorrhage
Author: Sallinen, Hanne; Putaala, Jukka; Strbian, Daniel
Contributor organization: Neurologian yksikkö
Helsinki University Hospital Area
HUS Neurocenter
University of Helsinki
Department of Neurosciences
Date: 2020-08
Language: eng
Number of pages: 7
Belongs to series: Journal of Stroke & Cerebrovascular Diseases
ISSN: 1052-3057
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104921
URI: http://hdl.handle.net/10138/330639
Abstract: Background: In ischemic stroke and subarachnoid hemorrhage, there are known preceding triggering events that predispose to the stroke by, for example, abruptly raising blood pressure. We explored, whether triggering events can be identified in non-traumatic intracerebral hemorrhage (ICH). Methods: We used structured questionnaires to interview consented patients with ICH treated in a tertiary teaching hospital, between 2014 and 2016. We asked of possible trigger factors, including Valsalva-inducing activity, heavy physical exertion, sexual activity, abrupt change in position, a heavy meal, a sudden change in temperature, exposure to traffic jam, and the combination of the first three (any physical trigger) during the hazard period of 0-2 h prior to ICH. The ratio of the reported trigger during the hazard period was compared to the same 2-h period the previous day (control period) to calculate the relative risks for each factor (case-crossover design). Results: Of our 216 consented ICH patients, 97 (35.0%) could be interviewed for trigger questions. Reasons for not able to provide consistent and reliable responses included lowered level of consciousness, delirium, impaired memory, and aphasia. None of the studied possible triggers alone were more frequent during the hazard period compared to the control period. However, when all physical triggers were combined, we found an association with the triggering event and onset of ICH (risk ratio 1.32, 95% confidence interval 1.01-1.73). Conclusions: Obtaining reliable information on the preceding events before ICH onset was challenging. However, we found that physical triggers as a group were associated with the onset of ICH.
Subject: Intracerebral hemorrhage
Risk factor
Trigger
Stroke
ACUTE MYOCARDIAL-INFARCTION
HEAVY PHYSICAL EXERTION
CASE-CROSSOVER
RISK-FACTORS
STROKE
POPULATION
EXERCISE
PRESSURE
ONSET
3112 Neurosciences
3124 Neurology and psychiatry
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: acceptedVersion


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