Frequency, Predictors, Etiology, and Outcomes for Deep Intracerebral Hemorrhage without Hypertension

Autor: Prats-Sánchez L., Iruzubieta P., Vesperinas A., Collet R., Martínez-Domeño A., Guisado-Alonso D., Camps-Renom P., Delgado-Mederos R., Guasch-Jiménez M., Ramos-Pachón A., Rodríguez-Antigüedad J., Campo-Caballero D., Equiza J., de la Riva P., Martínez-Zabaleta M., de Arce A., Martí-Fàbregas J.
Rok vydání: 2022
Předmět:
retrospective study
clinical outcome
thrombocytopenia
heparin
anticoagulant agent
middle aged
echocardiography
atrial fibrillation
nuclear magnetic resonance imaging
drug abuse
leukoaraiosis
antithrombocytic agent
neurological deficit score
aged
female
risk factor
brain angiography
frequency
diabetes mellitus
antihypertensive agent
brain hemorrhage
end stage liver disease
tertiary care center
adrenergic receptor stimulating agent
hospitalization
prospective study
hypertension
diagnostic imaging
alcohol consumption
brain
electrocardiography
congenital blood vessel malformation
tobacco use
electrocardiogram
Article
transthoracic echocardiography
male
blood clotting disorder
Rankin scale
ischemic stroke
follow up
controlled study
human
deterioration
dyslipidemia
international normalized ratio
platelet count
major clinical study
blood pressure monitoring
hospital discharge
age
treatment outcome
Zdroj: Journal of Stroke & Cerebrovascular Diseases
r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname
ISSN: 1052-3057
DOI: 10.1016/j.jstrokecerebrovasdis.2021.106293&partnerID=40&md5=1928fd6630de0b9b615f5ee0473811f4
Popis: Objectives: Some patients with deep intracerebral hemorrhage (ICH) have a transient hypertensive response and they may be erroneously classified as secondary to hypertension. We investigated frequency, risk factors, and outcomes for patients with deep ICH without hypertension. Materials and methods: We consecutively recruited patients with spontaneous ICH attending two Spanish stroke centers (January 2015-June 2019). Excluded were patients with lobar/infratentorial ICH and patients who died during hospitalization. We defined deep ICH without hypertension when the bleeding was in a deep structure, no requirement for antihypertensive agents during follow-up and no evident chronic hypertension markers evaluated by transthoracic echocardiography, 24 h ambulatory blood pressure monitoring and/or electrocardiography. We compared clinical, radiological, and 3-month functional outcome data for deep-ICH patients with hypertension versus those without hypertension. Results: Of 759 patients with ICH, 219 (mean age 69.6 ± 15.4 years, 54.8% men) met the inclusion criteria and 36 (16.4%) did not have hypertension. Of these 36 patients, 19 (52.7%) had a transient hypertensive response. Independent predictors of deep ICH without hypertension were age (adjusted OR:0.94;95%CI:0.91–0.96) and dyslipidemia (adjusted OR:0.27;95% CI:0.08–0.85). One third of deep ICH without hypertension were secondary to vascular malformations. Favorable outcomes (modified Rankin Scale 0–2) were more frequent in patients with deep ICH without hypertension compared to those with hypertension (70.9% vs 33.8%; p < 0.001). Conclusion: Of patients with deep ICH, 16.4% were unrelated with hypertension, around half showed hypertensive response, and around a third had vascular malformations. We suggest studying hypertension markers and performing a follow-up brain MRI in those patients with deep ICH without prior hypertension. © 2021 Elsevier Inc.
Databáze: OpenAIRE
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