Convexity subarachnoid hemorrhage in lobar intracerebral hemorrhage: A prognostic marker.

Autor:	Raposo N; From the Stroke Research Center (N.R., A.C., D.R., M.O., M.E.G., J.R., S.M.G., J.N.G., A.V.), Department of Neurology, Division of Neurocritical Care and Emergency Neurology (J.R., J.N.G.), Center for Genomic Medicine (J.R.), and Henry and Allison McCance Center for Brain Health (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (N.R.), Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse; Toulouse NeuroImaging Center (N.R.), Université de Toulouse, Inserm, UPS, France; and Division of Neurology (D.R.), Faculty of Medicine, Department of Medicine, Naresuan University, Phitsanulok, Thailand. raposo.n@chu-toulouse.fr., Charidimou A; From the Stroke Research Center (N.R., A.C., D.R., M.O., M.E.G., J.R., S.M.G., J.N.G., A.V.), Department of Neurology, Division of Neurocritical Care and Emergency Neurology (J.R., J.N.G.), Center for Genomic Medicine (J.R.), and Henry and Allison McCance Center for Brain Health (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (N.R.), Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse; Toulouse NeuroImaging Center (N.R.), Université de Toulouse, Inserm, UPS, France; and Division of Neurology (D.R.), Faculty of Medicine, Department of Medicine, Naresuan University, Phitsanulok, Thailand., Roongpiboonsopit D; From the Stroke Research Center (N.R., A.C., D.R., M.O., M.E.G., J.R., S.M.G., J.N.G., A.V.), Department of Neurology, Division of Neurocritical Care and Emergency Neurology (J.R., J.N.G.), Center for Genomic Medicine (J.R.), and Henry and Allison McCance Center for Brain Health (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (N.R.), Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse; Toulouse NeuroImaging Center (N.R.), Université de Toulouse, Inserm, UPS, France; and Division of Neurology (D.R.), Faculty of Medicine, Department of Medicine, Naresuan University, Phitsanulok, Thailand., Onyekaba M; From the Stroke Research Center (N.R., A.C., D.R., M.O., M.E.G., J.R., S.M.G., J.N.G., A.V.), Department of Neurology, Division of Neurocritical Care and Emergency Neurology (J.R., J.N.G.), Center for Genomic Medicine (J.R.), and Henry and Allison McCance Center for Brain Health (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (N.R.), Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse; Toulouse NeuroImaging Center (N.R.), Université de Toulouse, Inserm, UPS, France; and Division of Neurology (D.R.), Faculty of Medicine, Department of Medicine, Naresuan University, Phitsanulok, Thailand., Gurol ME; From the Stroke Research Center (N.R., A.C., D.R., M.O., M.E.G., J.R., S.M.G., J.N.G., A.V.), Department of Neurology, Division of Neurocritical Care and Emergency Neurology (J.R., J.N.G.), Center for Genomic Medicine (J.R.), and Henry and Allison McCance Center for Brain Health (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (N.R.), Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse; Toulouse NeuroImaging Center (N.R.), Université de Toulouse, Inserm, UPS, France; and Division of Neurology (D.R.), Faculty of Medicine, Department of Medicine, Naresuan University, Phitsanulok, Thailand., Rosand J; From the Stroke Research Center (N.R., A.C., D.R., M.O., M.E.G., J.R., S.M.G., J.N.G., A.V.), Department of Neurology, Division of Neurocritical Care and Emergency Neurology (J.R., J.N.G.), Center for Genomic Medicine (J.R.), and Henry and Allison McCance Center for Brain Health (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (N.R.), Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse; Toulouse NeuroImaging Center (N.R.), Université de Toulouse, Inserm, UPS, France; and Division of Neurology (D.R.), Faculty of Medicine, Department of Medicine, Naresuan University, Phitsanulok, Thailand., Greenberg SM; From the Stroke Research Center (N.R., A.C., D.R., M.O., M.E.G., J.R., S.M.G., J.N.G., A.V.), Department of Neurology, Division of Neurocritical Care and Emergency Neurology (J.R., J.N.G.), Center for Genomic Medicine (J.R.), and Henry and Allison McCance Center for Brain Health (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (N.R.), Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse; Toulouse NeuroImaging Center (N.R.), Université de Toulouse, Inserm, UPS, France; and Division of Neurology (D.R.), Faculty of Medicine, Department of Medicine, Naresuan University, Phitsanulok, Thailand., Goldstein JN; From the Stroke Research Center (N.R., A.C., D.R., M.O., M.E.G., J.R., S.M.G., J.N.G., A.V.), Department of Neurology, Division of Neurocritical Care and Emergency Neurology (J.R., J.N.G.), Center for Genomic Medicine (J.R.), and Henry and Allison McCance Center for Brain Health (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (N.R.), Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse; Toulouse NeuroImaging Center (N.R.), Université de Toulouse, Inserm, UPS, France; and Division of Neurology (D.R.), Faculty of Medicine, Department of Medicine, Naresuan University, Phitsanulok, Thailand., Viswanathan A; From the Stroke Research Center (N.R., A.C., D.R., M.O., M.E.G., J.R., S.M.G., J.N.G., A.V.), Department of Neurology, Division of Neurocritical Care and Emergency Neurology (J.R., J.N.G.), Center for Genomic Medicine (J.R.), and Henry and Allison McCance Center for Brain Health (J.R.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology (N.R.), Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse; Toulouse NeuroImaging Center (N.R.), Université de Toulouse, Inserm, UPS, France; and Division of Neurology (D.R.), Faculty of Medicine, Department of Medicine, Naresuan University, Phitsanulok, Thailand.
Jazyk:	angličtina
Zdroj:	Neurology [Neurology] 2020 Mar 03; Vol. 94 (9), pp. e968-e977. Date of Electronic Publication: 2020 Feb 04.
DOI:	10.1212/WNL.0000000000009036
Abstrakt:	Objective: To investigate whether acute convexity subarachnoid hemorrhage (cSAH) associated with acute lobar intracerebral hemorrhage (ICH) increases the risk of ICH recurrence in patients with cerebral amyloid angiopathy (CAA). Methods: We analyzed data from a prospective cohort of consecutive survivors of acute spontaneous lobar ICH fulfilling the Boston criteria for possible or probable CAA (CAA-ICH). We analyzed baseline clinical and MRI data, including cSAH (categorized as adjacent or remote from ICH on a standardized scale), cortical superficial siderosis (cSS), and other CAA MRI markers. Multivariable Cox regression models were used to assess the association between cSAH and recurrent symptomatic ICH during follow-up. Results: We included 261 CAA-ICH survivors (mean age 76.2 ± 8.7 years). Of them, 166 (63.6%, 95% confidence interval [CI] 57.7%-69.5%) had cSAH on baseline MRI. During a median follow-up of 28.3 (interquartile range 7.2-57.0) months, 54 (20.7%) patients experienced a recurrent lobar ICH. In Cox regression, any cSAH, adjacent cSAH, and remote cSAH were independent predictors of recurrent ICH after adjustment for other confounders, including cSS. Incidence rate of recurrent ICH in patients with cSAH was 9.9 per 100 person-years (95% CI 7.3-13.0) compared with 1.2 per 100 person-years (95% CI 0.3-3.2) in those without cSAH (adjusted hazard ratio 7.5, 95% CI 2.6-21.1). Conclusion: In patients with CAA-related acute ICH, cSAH (adjacent or remote from lobar ICH) is commonly observed and heralds an increased risk of recurrent ICH. cSAH may help stratify bleeding risk and should be assessed along with cSS for prognosis and clinical management. (© 2020 American Academy of Neurology.)
Databáze:	MEDLINE
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