Intracerebral Hemorrhage: Advances and Perspectives

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: 31 January 2026 | Viewed by 452

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Dear Colleagues,

The spectrum of cerebral hemorrhage is wide. The association between vascular risk factors and the progression of cerebral diseases remains partially unknown and has been the subject of many studies. Along with this, small vessel disorders are being better identified with the advancement of imaging technologies, especially magnetic resonance imaging (MRI).

From failures in the blood–brain barrier (BBB), which is the structure that regulates the transport of substances between the blood and the central nervous system, to morphofunctional dysfunctions, hemorrhages can present themselves in different ways.

The BBB, other than controling the entry of toxic substances and excess plasma hormones, also has an important role in the flow of blood cell elements. In this context, cerebral microhemorrhage (CMB) is a potential marker for the diagnosis and prognosis of cerebral damage. These focal deposits of hemosiderin indicate prior microhemorrhages around small vessels, and can be related to either ruptured atherosclerotic microvessels or amyloid angiopathy.

With more severe outcomes, intracerebral hemorrhage (ICH), in turn, is caused by bleeding within brain tissue itself, in a life-threatening type of stroke. Deprivation of oxygen and blood supply associated with ICH is most commonly caused by hypertension, arteriovenous malformations, or head trauma.

In addition to the previously mentioned pathophysiological disorders, cerebral hemorrhages can also be a reflection of morphoanatomical changes, such as microangiopathy. This microvessel disease, with small blood vessels in the microcirculation, also called microvascular dysfunction, microvascular disease, or small vessel disease (SVD), may be responsible for bleeding situations not necessarily related to biomolecular factors.

That said, this Special Issue of Life is intended to be a collection of reviews and original studies, containing up-to-date and innovative research on brain hemorrhages and their outcomes.

Dr. Ane Claudia Fernandes Nunes
Guest Editor

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Keywords

  • intracerebral hemorrhage
  • microangiopathic disease
  • cerebral microhemorrhages blood–brain barrier
  • small vessel disease

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Published Papers (1 paper)

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17 pages, 2624 KiB  
Article
Cerebral Hemodynamics as a Diagnostic Bridge Between Mild Cognitive Impairment and Late-Life Depression: A Multimodal Approach Using Transcranial Doppler and MRI
by Sergiu-Florin Arnautu, Diana-Aurora Arnautu, Minodora Andor, Cristina Vacarescu, Dragos Cozma, Brenda-Cristina Bernad, Catalin Juratu, Adrian Tutelca and Catalin-Dragos Jianu
Life 2025, 15(8), 1246; https://doi.org/10.3390/life15081246 - 6 Aug 2025
Viewed by 313
Abstract
Background: Vascular dysfunction is increasingly recognized as a shared contributor to both cognitive impairment and late-life depression (LLD). However, the combined diagnostic value of cerebral hemodynamics, neuroimaging markers, and neuropsychological outcomes remains underexplored. This study aimed to investigate the associations be-tween transcranial Doppler [...] Read more.
Background: Vascular dysfunction is increasingly recognized as a shared contributor to both cognitive impairment and late-life depression (LLD). However, the combined diagnostic value of cerebral hemodynamics, neuroimaging markers, and neuropsychological outcomes remains underexplored. This study aimed to investigate the associations be-tween transcranial Doppler (TCD) ultrasound parameters, cognitive performance, and depressive symptoms in older adults with mild cognitive impairment (MCI) and LLD. Importantly, we evaluated the integrative value of TCD-derived indices alongside MRI-confirmed white matter lesions (WMLs) and standardized neurocognitive and affective assessments. Methods: In this cross-sectional study, 96 older adults were enrolled including 78 cognitively unimpaired individuals and 18 with MCI. All participants underwent structured clinical, neuropsychological, and imaging evaluations including the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale (GDS-15), MRI-based Fazekas scoring of WMLs, and TCD ultrasonography of the middle cerebral artery. Hemodynamic variables included mean blood flow velocity (MBFV), end-diastolic velocity (EDV), pulsatility index (PI), and resistive index (RI). Logistic regression and receiver operating characteristic (ROC) analyses were used to identify independent predictors of MCI. Results: Participants with MCI showed significantly lower MBFV and EDV, and higher PI and RI (p < 0.05 for all) compared with cognitively unimpaired participants. In multivariate analysis, lower MBFV (OR = 0.64, p = 0.02) and EDV (OR = 0.70, p = 0.03), and higher PI (OR = 3.2, p < 0.01) and RI (OR = 1.9, p < 0.01) remained independently associated with MCI. ROC analysis revealed excellent discriminative performance for RI (AUC = 0.919) and MBFV (AUC = 0.879). Furthermore, PI correlated positively with depressive symptom severity, while RI was inversely related to the GDS-15 scores. Conclusions: Our findings underscore the diagnostic utility of TCD-derived hemodynamic parameters—particularly RI and MBFV—in identifying early vascular contributions to cognitive and affective dysfunction in older adults. The integration of TCD with MRI-confirmed WML assessment and standardized cognitive/mood measures represents a novel and clinically practical multi-modal approach for neurovascular profiling in aging populations. Full article
(This article belongs to the Special Issue Intracerebral Hemorrhage: Advances and Perspectives)
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