Can novel CT-and MR-based neuroimaging biomarkers further improve the etiological diagnosis of lobar intra-cerebral hemorrhage?

Jensen‐Kondering, Ulf; Sacco, Simona; Posener, Sacha; Benzakoun, Joseph; Pallud, Johan; Oppenheim, Catherine; Varlet, Pascale; Turc, Guillaume

doi:10.1007/s00415-022-11434-y

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“…However, survivors of cerebral hemorrhage are often accompanied by many neurological sequelae that impair quality of life. In clinical treatment, it is necessary to distinguish ICH subtypes in patients with ICH, as the risk of recurrence of cerebral amyloid angiopathy (CAA)-related ICH is approximately 7% per year [ 5 ], and the risk of recurrence of non-CAA-related ICH is significantly lower. Moreover, the differentiation of cerebral hemorrhage subtypes is also meaningful for later clinical decision-making.…”

Section: Introductionmentioning

confidence: 99%

Deep Medullary Vein and MRI Markers Were Related to Cerebral Hemorrhage Subtypes

Wang,

Xiang,

Peng

et al. 2023

Brain Sciences

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Background: To explore the performance of deep medullary vein (DMV) and magnetic resonance imaging (MRI) markers in different intracerebral hemorrhage (ICH) subtypes in patients with cerebral small vessel disease (CSVD). Methods: In total, 232 cases of CSVD with ICH were included in this study. The clinical and image data were retrospectively analyzed. Patients were divided into hypertensive arteriopathy (HTNA)-related ICH, cerebral amyloid angiopathy (CAA)-related ICH, and mixed ICH groups. The DMV score was determined in the cerebral hemisphere contralateral to the ICH. Results: The DMV score was different between the HTNA-related and mixed ICH groups (p < 0.01). The MRI markers and CSVD burden score were significant among the ICH groups (p < 0.05). Compared to mixed ICH, HTNA-related ICH diagnosis was associated with higher deep white matter hyperintensity (DWMH) (OR: 0.452, 95% CI: 0.253–0.809, p < 0.05) and high-degree perivascular space (PVS) (OR: 0.633, 95% CI: 0.416–0.963, p < 0.05), and CAA-related ICH diagnosis was associated with increased age (OR: 1.074; 95% CI: 1.028–1.122, p = 0.001). The DMV score correlated with cerebral microbleed (CMB), PVS, DWMH, periventricular white matter hyperintensity (PWMH), and CSVD burden score (p < 0.05) but not with lacuna (p > 0.05). Age was an independent risk factor for the severity of DMV score (OR: 1.052; 95% CI: 0.026–0.076, p < 0.001). Conclusion: DMV scores, CSVD markers, and CSVD burden scores were associated with different subtypes of ICH. In addition, DMV scores were associated with the severity of CSVD and CSVD markers.

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Section: Introductionmentioning

confidence: 99%