vard.edu. Day-Night Variability of Hematoma Expansion in Patients with Spontaneous Intracerebral Hemorrhage

Abstract The levels of several coagulation factors, able to influence hemo-static balance, display circadian variations. We hypothesized that the onset and extent of hematoma expansion (HE) following intracerebral hemorrhage (ICH) also display diurnal patterns. We reviewed clinical, laboratory, and radiological data from 111 consecutive patients with spontaneous ICH who had baseline head computed tomography (CT) scans within 3 h of ICH onset and follow-up CT during the following 72 h. We defined any HE (AHE) as any increase in hematoma volume from baseline to follow-up CT and significant HE (SHE) as an absolute increase in hematoma volume>6 mL or relative increase>33%. We categorized the patients into 2 groups based on the timing of the initial CT scans—day group (from 0800 to 2000 h) and night group (from 2000 to 0800 h)—and performed logistic regression analyses. We also analyzed the differences in the rates of HE between the groups during six 4-h periods spanning 24 h, using χ2 tests. We found that the rates of AHE and SHE were higher in the day versus night group (75 % vs. 48%; p = 0.009 for AHE an