The effect of acetazolamide on intracerebral hemorrhage in stoke patients

Authors

  • Vahid Abbasi Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran
  • Maryam Salimi Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran
  • Firouz Amani Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran

DOI:

https://doi.org/10.18203/2349-3933.ijam20170099

Keywords:

Acetazolamide, Cerebral haemorrhage, Rankin scale

Abstract

Background: 10-20% of all strokes are caused by intracerebral haemorrhage which is the world's leading cause of neural tube defects and the second cause of mortality in the world. The aim of this study was to assessment the effect of acetazolamide in the symptom improvement, decreasing rankin scale and mortality rate in patients with intracerebral haemorrhage.

Methods: This is a clinical trial study that has been done on 120 stroke patients which divided randomly in two groups each with 60 patients. Patients in intervention group take acetazolamide 750 mg/day and in control group take placebo. The status of patients investigated by Rankin scale in three times baseline, 72 hours and 3 weeks after Cerebral haemorrhage.

Results: Of all patients, 49 (40.8%) were male and 71 (59.1%) were female. Putamen haemorrhage is the most location for cerebral haemorrhage (n = 43, 35.8%). According to the Rankin scale, 53 (44.2%) of patients were in the status 4 “moderately severe disability. Unable to attend to own bodily needs without assistance and unable to walk unassisted” in baseline. In the intervention group based on Rankin scale after 72 hour and three week the recovery rate was significantly more than control group.

Conclusions: Acetazolamide can be effective in treatment haemorrhagic stroke, decreasing Rankin scale and mortality rate in patients with cerebral haemorrhage.

References

Tran J, Mirzaei M, Anderson L, Leeder SR. The epidemiology of stroke in the middle east and North Africa. J Neurol Sci. 2010;295(1):38-40.

Estol CJ, Rojas MM. Stroke in Argentina. Int J Stroke. 2010;5(1):35-9.

Grysiewicz RA, Thomas K, Pandey DK. Epidemiology of ischemic and hemorrhagic stroke: incidence, prevalence, mortality, and risk factors. Neurol Clin. 2008;26(4):871-95.

Ghandehari K, Mood Z. Khorasan stroke registry: analysis of 1392 stroke patients. Arch Iran Med. 2007;10(3):327-34.

Shaikh AK, Mohammad QD, Ullah MA, Ahsan MM, Rahman A, Shakoor MA. Effect of dexamethasone on brain oedema following acute ischemic stroke. Mymensingh Med J. 2011;20(3):450-8.

Daneshfard B, Izadi S, Shariat A, Toudaji MA, Beyzavi Z, Niknam L. Epidemiology of stroke in Shiraz, Iran. Iranian J Neurology. 2015;14(3):158-63 .

Eghlidi J, Shafiee Z, Vatandust M, Rezaee M, Jamebozorgi AA, Tabatabaee SM. Effects of mental practices on balance and quality of life in stroke. Journal Rehabilitation Med. 2015;4(4):20-7.

Sacco S, Ornello R, Ripa P, Pistoia F, Carolei A. Migraine and hemorrhagic stroke a meta-analysis. Stroke. 2013;44(11):3032-8.

Wang X, Dong Y, Qi X, Huang C, Hou L. Cholesterol levels and risk of hemorrhagic stroke a systematic review and meta-analysis. Stroke. 2013;44(7):1833-9.

Nieuwkamp DJ, Setz LE, Algra A, Linn FH, de Rooij NK Rinkel GJ. Changes in case fatality of aneurysmal subarachnoid haemorrhage over time, according to age, sex, and region: a meta-analysis. Lancet Neurol. 2009;8:635-42.

Asch CJ, Luitse MJ, Rinkel GJ, Tweel I, Algra A, Klijn CJ. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex and ethnic origin: a systematic review and meta-analysis. Lancet Neurol. 2010;9:167-76.

Pérez GA, Gaist D, Wallander MA, Mcfeat G, Rodríguez LA. Mortality after hemorrhagic stroke Data from general practice (The Health Improvement Network). Neurology. 2013;81(6):559-65.

Ronkainen A, Niskanen M, Rinne J, Koivisto T, Hernesniemi J, Vapalahti M. Evidence for excess long-term mortality after treated subarachnoid hemorrhage. Stroke. 2001;32:2850-3.

Molyneux AJ, Kerr RS, Birks J. Risk of recurrent subarachnoid haemorrhage, death, or dependence and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the International Subarachnoid Aneurysm Trial (ISAT): long-term follow-up. Lancet Neurol. 2009;8:427-33.

Lee SM, Choi NK, Yoon BW, Park JM, Han MK, Park BJ. The impact of green tea consumption on the prevention of hemorrhagic stroke. Neuroepidemiology. 2015;44(4):215-20.

Vorstrup S, Henriksen L, Paulson OB. Effect of acetazolamide on cerebral blood flow and cerebral metabolism rate for oxygen. J Clin Invest. 1984;74:1634-9.

Friis ML, Paulson OB, Hertz MM. Carbon dioxide permeability of the blood-brain barrier in man. The effect of acetazolamide. Microvasc Res. 1980;20:71-80.

Sharafadinzadeh N, Baghebanian SM, Pipelzadeh M, Moravej A, Ghanavati P. Effects of dexamethasone in primary intracerebral hemorrhage in the South West of Iran. Pak J Med Sci. 2008;24(4):502-5.

Sia SF, Tan KS, Waran V. Primary intracerebral haemorrhage in Malaysia: in-hospital mortality and outcome in patients from a hospital based registry. Med J Malaysia. 2007;62(4):308-12.

Furuta Y, Ninomiya T. Epidemiology of stroke in Japan and comparison with the world. Nihon rinsho Japanese Journal Clinical Medicine. 2016;74(4):549.

Guo F, Hua Y, Wang JF, Keep R, Xi G. Inhibition of carbonic anhydrase reduces brain injury after intracerebral hemorrhage. Transl Stroke Res. 2012;3(1):130-7.

Bøthun ML, Haaland ØA, Logallo N, Svendsen F, Thomassen L, Helland CA. Cerebrovascular reactivity after treatment of unruptured intracranial aneurysms a transcranial Doppler sonography and acetazolamide study. Journal Neurol Sci. 2016;363:97-103.

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Published

2017-01-23

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Original Research Articles