{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T22:55:34Z","timestamp":1793228134680,"version":"4.5.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>In patients with intracerebral hemorrhage (ICH), it is unclear whether early neurological deterioration, hematoma expansion (HE), and outcome vary by supratentorial ICH location (deep versus lobar). Herein, we assessed these relationships in a clinical trial cohort that underwent brain imaging early after symptom onset. We hypothesized that HE would occur more frequently, and outcome would be worse in patients with deep ICH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a post hoc analysis of the FAST (Factor-VII-for-Acute-Hemorrhagic-Stroke-Treatment) trial including all patients with supratentorial hemorrhage. Enrolled patients underwent brain imaging within 3 hours of symptom onset and 24 hours after randomization. Multivariable regression was used to test the association between ICH location and 3 outcomes: HE (increase of \u226533% or 6mL), early neurological deterioration (decrease in Glasgow Coma Scale score \u22652 points or increase in National Institutes of Health Stroke Scale \u22654 points within 24 hours of admission), and 90-day outcome (modified Rankin Scale).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 841 FAST trial patients, we included 728 (mean age 64 years, 38% women) with supratentorial hemorrhages (deep n=623, lobar n=105). HE (44 versus 27%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.001) and early neurological deterioration (31 versus 17%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.001) were more common in lobar hemorrhages. Deep hemorrhages were smaller than lobar hemorrhages at baseline (12 versus 35mL,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001) and 24 hours (14 versus 38mL,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.001). Unadjusted 90-day outcome was worse in lobar compared with deep ICH (median modified Rankin Scale score 5 versus 4,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.03). However, when adjusting for variables included in the ICH score including ICH volume, deep location was associated with worse and lobar location with better outcome (odds ratio lobar location, 0.58 [95% CI, 0.38\u20130.89];\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      =0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>In this secondary analysis of randomized trial patients, lobar ICH location was associated with larger ICH volume, more HE and early neurological deterioration, and worse outcome than deep ICH. After adjustment for prognostic variables, however, deep ICH was associated with worse outcome, likely due to their proximity to eloquent brain structures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.121.037974","type":"journal-article","created":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T05:00:45Z","timestamp":1648789245000},"page":"2441-2448","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":72,"title":["Early Deterioration, Hematoma Expansion, and Outcomes in Deep Versus Lobar Intracerebral Hemorrhage: The FAST Trial"],"prefix":"10.1161","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9500-6162","authenticated-orcid":true,"given":"Lindsey R.","family":"Kuohn","sequence":"first","affiliation":[{"name":"NYU Grossman School of Medicine, NY (L.R.K.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8924-851X","authenticated-orcid":true,"given":"Jens","family":"Witsch","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia (J.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5080-8222","authenticated-orcid":true,"given":"Thorsten","family":"Steiner","sequence":"additional","affiliation":[{"name":"Department of Neurology, Klinikum Frankfurt H\u00f6chst, Frankfurt a. M., Germany (T.S.)."},{"name":"Department of Neurology, Universit\u00e4t Heidelberg, Germany (T.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2003-5473","authenticated-orcid":true,"given":"Kevin N.","family":"Sheth","sequence":"additional","affiliation":[{"name":"Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, Yale New Haven Hospital, CT (K.N.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5745-0307","authenticated-orcid":true,"given":"Hooman","family":"Kamel","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Department of Neurology, Weill Cornell Medicine, New York (H.K., B.B.N., A.E.M., S.B.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8424-6128","authenticated-orcid":true,"given":"Babak B.","family":"Navi","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Department of Neurology, Weill Cornell Medicine, New York (H.K., B.B.N., A.E.M., S.B.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2211-299X","authenticated-orcid":true,"given":"Alexander E.","family":"Merkler","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Department of Neurology, Weill Cornell Medicine, New York (H.K., B.B.N., A.E.M., S.B.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4950-0992","authenticated-orcid":true,"given":"Santosh B.","family":"Murthy","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit, Feil Family Brain and Mind Research Institute, Department of Neurology, Weill Cornell Medicine, New York (H.K., B.B.N., A.E.M., S.B.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1272-6277","authenticated-orcid":true,"given":"Stephan A.","family":"Mayer","sequence":"additional","affiliation":[{"name":"Departments of Neurology and Neurosurgery, New York Medical College, Valhalla, NY (S.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(20)30069-3"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s42466-021-00120-5"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/wnl.44.8.1379"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182143317"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.66.5.600"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1385\/NCC:4:3:206"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.114.007704"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-018-00668-2"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2013.5433"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2015.11.024"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000010990"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000069"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.013"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707534"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.23629"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001344"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2020-323458"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30253-9"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.2636"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.121.034392"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.1141"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000012393"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60986-1"},{"key":"e_1_3_3_25_2","unstructured":"Nico Corporation. ENRICH: a multi-center randomized clinical trial comparing standard medical management to early surgical hematoma evacuation using Minimally Invasive Parafascicular Surgery (MIPS) in the treatment of Intracerebral Hemorrhage (ICH). [Internet]. clinicaltrials.gov; 2021. Accessed September 7 2021. https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02880878"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.06.089"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-020-04284-y"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.119.028338"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.121.037974","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T12:45:14Z","timestamp":1762865114000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.121.037974"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8]]},"references-count":27,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2022,8]]}},"alternative-id":["10.1161\/STROKEAHA.121.037974"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.121.037974","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8]]},"assertion":[{"value":"2021-11-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-12","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-03-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-04-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}