Geometric features of middle cerebral artery are associated with spontaneous basal ganglia intracerebral haemorrhage

Liu, Dehan; Zhang, Guopeng; Wang, Yingliang; Li, Jing; Cao, Peng; Yin, Xiaoxv; Zhou, Changjun; Wang, Mengdie

doi:10.1136/svn-2021-001277

Cited by 3 publications

(1 citation statement)

References 28 publications

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“…Specifically, terminal blood supply with a lack of anastomoses between parenteral vessels [ 85 ] and high excitotoxic and oxidative stress [ 86 ] predisposes the BG to damage following ischemic or toxic insult. Certain individuals may have an increased risk for hemorrhage due to geometric feature variations of the middle cerebral artery that promote wall stress and injury [ 87 ], and the presence of other comorbid conditions such as hypertension, heart disease, diabetes, excessive alcohol consumption, and smoking [ 88 , 89 ].…”

Section: Discussionmentioning

confidence: 99%

Bilateral basal ganglia hemorrhage: a systematic review of etiologies, management strategies, and clinical outcomes

et al. 2023

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Bilateral basal ganglia hemorrhages (BBGHs) represent rare accidents, with no clear standard of care currently defined. We reviewed the literature on BBGHs and analyzed the available conservative and surgical strategies. PubMed, Scopus, Web of Science, and Cochrane were searched following the PRISMA guidelines to include studies reporting patients with BBGHs. Clinical characteristics, management, and outcomes were analyzed. We included 64 studies comprising 75 patients, 25 (33%) traumatic and 50 (67%) non-traumatic. Traumatic cases affected younger patients (mean age 35 vs. 46 years, p =0.014) and males (84% vs. 71%, p =0.27) and were characterized by higher proportion of normal blood pressures at admission (66% vs. 13%, p =0.0016) compared to non-traumatic cases. Most patients were comatose at admission (56%), with a mean Glasgow Coma Scale (GCS) score of 7 and a higher proportion of comatose patients in the traumatic than in the non-traumatic group (64% vs. 52%, p =0.28). Among the traumatic group, motor vehicle accidents and falls accounted for 79% of cases. In the non-traumatic group, hemorrhage was most associated with hypertensive or ischemic (54%) and chemical (28%) etiologies. Management was predominantly conservative (83%). Outcomes were poor in 56% of patients with mean follow-up of 8 months. Good recovery was significantly higher in the traumatic than in the non-traumatic group (48% vs. 17%, p =0.019). BBGHs are rare occurrences with dismal prognoses. Standard management follows that of current intracerebral hemorrhage guidelines with supportive care and early blood pressure management. Minimally invasive surgery is promising, though substantial evidence is required to outweigh the potentially increased risks of bilateral hematoma evacuation. Supplementary Information The online version contains supplementary material available at 10.1007/s10143-023-02044-x.

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Section: Discussionmentioning

confidence: 99%

Bilateral basal ganglia hemorrhage: a systematic review of etiologies, management strategies, and clinical outcomes

et al. 2023

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Plaque features of the middle cerebral artery are associated with periprocedural complications of intracranial angioplasty and stenting

Meng,

Magigi,

Song

et al. 2023

Neuroradiology

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Predicting symptomatic intracranial hemorrhage in anterior circulation stroke patients with contrast enhancement after thrombectomy: the CAGA score

Chang

Nguyen

Qiu

et al. 2023

J NeuroIntervent Surg

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BackgroundThe aim of the study was to establish a reliable scoring tool to identify the probability of symptomatic intracranial hemorrhage (sICH) in anterior circulation stroke patients with contrast enhancement (CE) on brain non-contrast CT (NCCT) after endovascular thrombectomy (EVT).MethodsWe retrospectively reviewed consecutive patients with acute ischemic stroke (AIS) who had CE on NCCT immediately after EVT for anterior circulation large vessel occlusion (LVO). We used the Alberta stroke program early CT score (ASPECTS) scoring system to estimate the extent and location of CE. Multivariable logistic regression was performed to derive an sICH predictive score. The discrimination and calibration of this score were assessed using the area under the receiver operator characteristic curve, calibration curve, and decision curve analysis.ResultsIn this study, 194 of 322 (60.25%) anterior circulation AIS-LVO patients had CE on NCCT. After excluding 85 patients, 109 patients were enrolled in the final analysis. In multivariate regression analysis, age ≥70 years (adjusted OR (aOR) 9.23, 95% CI 2.43 to 34.97, P＜0.05), atrial fibrillation (AF) (aOR 4.17, 95% CI 1.33 to 13.12, P＜0.05), serum glucose ≥11.1 mmol/L (aOR 9.39, 95% CI 2.74 to 32.14, P＜0.05), CE-ASPECTS ＜5 (aOR 3.95, 95% CI 1.30 to 12.04 P＜0.05), and CE at the internal capsule (aOR 3.45, 95% CI 1.03 to 11.59, P＜0.05) and M1 region (aOR 3.65, 95% CI 1.13 to 11.80, P＜0.05) were associated with sICH. These variables were incorporated as the CE-age-glucose-AF (CAGA) score. The CAGA score demonstrated good discrimination and calibration in this cohort, as well as the fivefold cross validation.ConclusionThe CAGA score reliably predicted sICH in patients with CE on NCCT after EVT treatment.

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Geometric features of middle cerebral artery are associated with spontaneous basal ganglia intracerebral haemorrhage

Cited by 3 publications

References 28 publications

Bilateral basal ganglia hemorrhage: a systematic review of etiologies, management strategies, and clinical outcomes

Bilateral basal ganglia hemorrhage: a systematic review of etiologies, management strategies, and clinical outcomes

Plaque features of the middle cerebral artery are associated with periprocedural complications of intracranial angioplasty and stenting

Predicting symptomatic intracranial hemorrhage in anterior circulation stroke patients with contrast enhancement after thrombectomy: the CAGA score

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