Associations of Radiographic Cerebral Small Vessel Disease with Acute Intracerebral Hemorrhage Volume, Hematoma Expansion, and Intraventricular Hemorrhage
| Autor: | Andrea Morotti, Sandro Marini, Simone M. Uniken Venema, Jonathan Rosand, Daniel Woo, H. Bart Brouwers, Christopher D. Anderson |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Neurology Cerebral small vessel disease Cerebral atrophy Comorbidity 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Hematoma Atrophy Interquartile range Internal medicine medicine Humans cardiovascular diseases 10. No inequality Aged Cerebral Intraventricular Hemorrhage Cerebral Hemorrhage Intracerebral hemorrhage business.industry Leukoaraiosis Middle Aged medicine.disease Computerized tomography Intraventricular hemorrhage Cerebral Small Vessel Diseases Disease Progression Cardiology Female Neurology (clinical) business 030217 neurology & neurosurgery Original Work |
| Zdroj: | Neurocritical Care |
| ISSN: | 1556-0961 1541-6933 |
| Popis: | Background and Objective The aim of this study was to evaluate the impact of radiographic cerebral small vessel disease (CSVD) on the severity of acute intracerebral hemorrhage (ICH) as measured by: ICH volume, hematoma expansion, and extension of intraventricular hemorrhage (IVH). Methods CSVD was determined on baseline computed tomography (CT) scans of patients from the Ethnic and Racial Variations of Intracerebral Hemorrhage study through the extent of leukoaraiosis and cerebral atrophy using visual rating scales. The associations of leukoaraiosis and atrophy with ICH volume, hematoma expansion, IVH presence, and severity of IVH were tested using multivariable regression models. Secondary analyses were stratified by hemorrhage location. Bonferroni correction was applied to correct for multiple testing. Results A total of 2579 patients (mean age 61.7 years, 59% male) met inclusion criteria. Median ICH volume was 10.5 (Interquartile range [IQR] 4.0–25.3) mL. IVH was detected in 971 patients (38%). Neither leukoaraiosis nor atrophy was associated with hematoma expansion. Increasing grades of leukoaraiosis were associated with increased risk of IVH in a dose-dependent manner, while cerebral atrophy was inversely associated with IVH (both P for trend P Conclusions Leukoaraiosis and cerebral atrophy appear to have opposing associations with ICH severity. Cerebral atrophy correlates with smaller ICH volume and decreased risk and severity of IVH, while leukoaraiosis is associated with increased risk of IVH. Whether these observations reflect overlapping or divergent underlying mechanisms requires further study. |
| Databáze: | OpenAIRE |
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