This study retrospectively analyzed the association of blend sign with long-term outcomes in patients who underwent craniotomy following spontaneous supratentorial intracerebral hemorrhage.

A retrospective analysis was conducted on a cohort comprising 259 patients. Initially, patients were stratified into two groups: the blend sign group and the non-blend sign group. Subsequently, the neurological status of these patients was assessed using the NIHSS, GCS, and mRS following craniotomy. Furthermore, at six months post-craniotomy, patients were categorized into either the “good outcome group” or the “poor outcome group”. A multivariate regression analysis was applied to ascertain the independent correlation between the CT blend sign and prognosis.

No statistically significant disparities were observed in the proportion of patients experiencing favorable outcomes during the follow-up period between the two groups. Nevertheless, it is noteworthy that the incidence of the blend sign was higher among patients in the good outcome group compared to those in the poor outcome group. Multivariate regression analysis disclosed that poor outcomes following craniotomy was not associated with the blend sign.

The presence of the blend sign may not serve as a reliable predictor of functional outcomes in patients undergoing craniotomy for spontaneous supratentorial ICH.

The aim of the current study is to evaluate if ET_B inhibition following ICH can mitigate the deleterious impact of ET-1, e.g., BBB disruption, and improve neurological function.

A total of 90 male rabbits (2.8–3.4 kg) were randomly assigned to the following groups (n = 10 per group): normal control (NC), pseudo-control (PC), drug control using normal saline (DC), model control (MC + ICH), minimally invasive surgery (MIS + ICH), minimally invasive surgery + ET-1 receptor agonist (MIS + IRL1620 + ICH), IRL1620 + ICH, ET-1 receptor antagonist (BQ788 + ICH), and IS + BQ788 + ICH. ICH was induced in all groups except for NC, DC and PC groups.

The purdy score, ET-1, MDA, MMP-9, BWC, and BBB permeability were decreased in groups treated with BQ788 and increased in groups treated with IRL1620. The combination of MIS + BQ788 markedly decreased these deleterious outcomes (purdy score, ET-1, MDA, MMP-9, BWC, and BBB permeability) compared to the MIS group.

Using a non-selective antagonist of ET_B, deleterious outcomes associated with increased levels of ET-1 following ICH were ameliorated.

To explore the molecular mechanism involved in secondary brain damage caused by intracerebral hemorrhage (ICH), we activated microglia by thrombin, to observe the changes of peroxisome proliferator-activated receptor-gamma (PPARγ), nuclear factor E2-related factor 2 (Nrf2) and heme oxygenase 1 (HO-1) mRNA transcription and protein expression in the microglia cells of primary culturing in vitro.

Microglial cells were obtained from the brain tissues of the newborn rats and cultured in vitro. The isolated microglia cells were randomly divided into normal control group (NC group) and thrombin stimulation group (TH group). The expression of PPARγ, Nrf2 and HO-1 was tested by immunofluorescence and real-time PCR.

The immunofluorescence showed that the numbers of stained positive cells of PPARγ, Nrf2 and HO-1 in TH group was increased remarkably as compared with NC group. The results of RT-qPCR showed that the mRNA expression of PPARγ, Nrf2 and HO-1 in TH group was increased significantly as compared with NC group (P < 0.01).

The expression of PPARγ, Nrf2 and HO-1 in the microglia cells activated by the thrombin were increased. Therefore, the microglia could be activated by intracerebral hemorrhage and the anti-oxidative stress effects of microglia can be improved.