Abstract:
OBJECTIVE: Perihematomal edema of intracerebral hemorrhage (ICH) is caused by a hematoma-induced inflammatory reaction, which usually contributes to delayed deterioration of neurological function and poor outcomes. Celecoxib is a commonly used nonsteroidal anti-inflammatory drug that selectively inhibits cyclooxygenase-2. High-dose celecoxib (400 mg twice daily) for 14 days has been shown to reduce perihematomal edema and hematoma enlargement in patients with ICH, but without improvement in long-term functional outcome, which may be confounded by the heterogeneity of hematoma location. Low-dose celecoxib may be an effective management for symptoms caused by perihematomal edema in patients with ICH, particularly those involving the thalamus.
METHODS: We reported two patients with acute thalamic ICH; a common symptom between the two was delayed onset of drowsiness caused by perihematomal edema involving the thalamus. Their consciousness improved after low-dose celecoxib (200 mg once daily) administration for 3 and 2 days in case A and B, respectively. Furthermore, other symptoms that concomitantly improved included poor appetite caused by perihematomal edema involving the left hypothalamus in case A, and limb weakness caused by perihematomal edema of the internal capsule in case B.
CONCLUSIONS: These cases revealed that low-dose celecoxib may be an effective management for symptoms caused by perihematomal edema in patients with ICH, particularly those involving the thalamus.
摘要:
目的:脑出血(ICH)的血肿周围水肿是由血肿引起的炎症反应引起的,这通常有助于神经功能的延迟恶化和不良的结果。塞来昔布是一种常用的非甾体抗炎药,可选择性抑制环氧合酶-2。大剂量塞来昔布(400毫克,每日两次)14天已被证明可以减少ICH患者的血肿周围水肿和血肿扩大。但是长期功能结果没有改善,这可能与血肿位置的异质性有关。小剂量塞来昔布可能是ICH患者由血肿周围水肿引起的症状的有效治疗方法。特别是那些涉及丘脑的。
方法:我们报告了2例急性丘脑ICH患者;两者之间的共同症状是由丘脑周围血肿水肿引起的嗜睡延迟发作。在情况A和B中,低剂量塞来昔布(200mg,每日一次)给药3天和2天后,他们的意识得到改善。分别。此外,其他伴随改善的症状包括在病例A中由累及左下丘脑的血肿周围水肿引起的食欲不振,
结论:这些病例表明,小剂量塞来昔布可能是治疗脑出血患者由血球周围水肿引起的症状的有效方法,特别是那些涉及丘脑的。