How the clinical characteristics and prognosis of various types of vascular structural abnormality–related intracerebral hemorrhage (ICH) differ from those of hypertensive ICH is poorly understood. This lack of understanding poses a problem for differential diagnosis and prognosis.
Patients diagnosed with ICH between January 2012 and February 2014 at 50 tertiary and secondary hospitals in China were enrolled into this prospective cohort study. Patients were classified as having vascular structural abnormality–related ICH or hypertensive ICH, and data on the demographics and clinical characteristics of each group were compared. Multivariate logistic regression was used to explore associations while controlling for other risk factors for good outcome and mortality.
Data for 281 patients showed that vascular structural abnormality–related ICH usually occurred in lobar areas and affected patients who were younger and had higher Glasgow Coma Scale (GCS) scores than those with hypertensive ICH. Mortality and good outcome at 3 months after ICH were significantly better among patients with vascular structural abnormality–related ICH (3.4% and 77.2%) than among patients with hypertensive ICH (15.2% and 49.9%, both P < .001). Multivariate logistic regression identified the following independent predictors of mortality: lower GCS score, old age, presence of intraventricular hemorrhage, larger hematoma volume, and surgery treatment. The regression also identified several independent predictors of good outcome at 3 months: ICH etiology due to vascular structural abnormality, higher GCS score, younger age, and smaller hematoma volume.
Patients with vascular structural abnormality–related ICH are more likely to experience better clinical outcomes than those with hypertensive ICH. GCS score, age, hematoma volume, and ICH etiology are independent predictors of ICH outcome.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Stroke and Cerebrovascular Diseases
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Recommendations for the management of intracranial haemorrhage-part I: spontaneous intracerebral haemorrhage. The European Stroke Initiative Writing Committee and the Writing Committee for the EUSI Executive Committee.Cerebrovasc Dis. 2006; 22: 294-316
- Recommendations for the management of intracranial arteriovenous malformations: a statement for healthcare professionals from a special writing group of the Stroke Council, American Stroke Association.Circulation. 2001; 103: 2644-2657
- Outcome after spontaneous and arteriovenous malformation-related intracerebral haemorrhage: population-based studies.Brain. 2009; 132: 537-543
- Differences between intracranial vascular structural abnormality types in the characteristics of their presenting haemorrhages: prospective, population-based study.J Neurol Neurosurg Psychiatr. 2008; 79: 47-51
- Moyamoya disease-related versus primary intracerebral hemorrhage: [corrected] location and outcomes are different.Stroke. 2012; 43: 1947-1950
- Experience from a multicentre stroke register: a preliminary report.Bull World Health Organ. 1976; 54: 541-553
- The ABCs of measuring intracerebral hemorrhage volumes.Stroke. 1996; 27: 1304-1305
- The acute management of intracerebral hemorrhage: a clinical review.Anesth Analg. 2010; 110: 1419-1427
- Current imaging assessment and treatment of intracranial aneurysms.AJR Am J Roentgenol. 2011; 196: 32-44
- Diagnosing intracranial aneurysms with MR angiography: systematic review and meta-analysis.Stroke. 2014; 45: 119-126
- Clinical features, surgical treatment, and long-term outcome in adult patients with moyamoya disease. Clinical article.J Neurosurg. 2009; 111: 936-942
- Distinguishing intracerebral hemorrhages caused by arteriovenous malformations.Cerebrovasc Dis. 2003; 15: 206-209
- Brain arteriovenous malformations in adults.Lancet Neurol. 2005; 4: 299-308
- Morbidity of intracranial hemorrhage in patients with cerebral arteriovenous malformation.Stroke. 1998; 29: 931-934
- SMASH-U: a proposal for etiologic classification of intracerebral hemorrhage.Stroke. 2012; 43: 2592-2597
- Outcome in patients presenting with an aneurysm related intracerebral haemorrhage in the post-ISAT era.Br J Neurosurg. 2013; 27: 194-197
- Subarachnoid extension of intracerebral hemorrhage and 90-day outcomes in INTERACT2.Stroke. 2014; 45: 258-260
Published online: June 13, 2015
Accepted: April 3, 2015
Received in revised form: March 22, 2015
Received: December 10, 2014
This research was supported by the National Key Technology R&D Program for the 12th Five-year Plan of P. R. China (2011BAI08B05) and the National Natural Science Foundation of China (81371283, 81371282).
The authors declare that they have no conflicts of interest to disclose.
© 2015 Published by Elsevier Inc.