Background
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.
Methods
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.
Results
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.
Conclusions
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.
Key Words
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References
- 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
Article info
Publication history
Published online: June 13, 2015
Accepted:
April 3,
2015
Received in revised form:
March 22,
2015
Received:
December 10,
2014
Footnotes
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.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.04.006
Copyright
© 2015 Published by Elsevier Inc.
