<i>17p12</i>
            Influences Hematoma Volume and Outcome in Spontaneous Intracerebral Hemorrhage

Marini, Sandro; Devan, William J.; Radmanesh, Farid; Miyares, Laura; Poterba, Timothy; Hansen, Björn M.; Norrving, Bo; Jiménez‐Conde, Jordi; Giralt‐Steinhauer, Eva; Elosúa, Roberto; Cuadrado-Godia, Elisa; Soriano, Carolina; Roquer, Jaume; Kourkoulis, Christina; Ayres, Alison; Schwab, Kristin; Tirschwell, David; Selim, Magdy; Brown, Devin L.; Silliman, Scott; Worrall, Bradford B.; Meschia, James F.; Kidwell, Chelsea S.; Montaner, Joan; Fernández‐Cadenas, Israel; Delgado, Pilar; Greenberg, Steven M.; Lindgren, Arne; Matouk, Charles; Sheth, Kevin N; Woo, Daniel; Anderson, Chris; Rosand, Jonathan; Falcone, Guido J

doi:10.1161/strokeaha.117.020091

Cited by 28 publications

(21 citation statements)

References 51 publications

(48 reference statements)

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“…Binary logistic regression was used for models investigating hematoma expansion and IVH presence. Linear regression was used for models predicting ICH volume, which was natural log-transformed to approximate a normal distribution [24]. Ordinal logistic regression was used for models predicting the Graeb Score, which was categorized as some (Graeb Score of 1-3), modest (Graeb Score of 4-6), or severe (Graeb Score of > 7) and was treated as an ordered response variable.…”

Section: Discussionmentioning

confidence: 99%

“…Patients meeting the following imaging-related criteria were excluded from further analysis: (1) unreliable baseline CT scan due to poor imaging quality, (2) large hydrocephalus, severe midline shift or global edema which made the acquisition of imaging variables impossible, (3) multiple ICH, and (4) primary IVH. The remaining scans were used to obtain the following variables: ICH location, categorized as lobar versus non-lobar as previously done [24], ICH and IVH volumes, using semiautomated computerized volumetric analysis (Alice software, Parexel Corporation, Waltham, MA). The presence of IVH was defined as an IVH volume measurement of > 0.…”

Section: Imaging Acquisition and Interpretationmentioning

confidence: 99%

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Associations of Radiographic Cerebral Small Vessel Disease with Acute Intracerebral Hemorrhage Volume, Hematoma Expansion, and Intraventricular Hemorrhage

et al. 2019

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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 < 0.001). Increasing grades of global atrophy were dose-dependently associated with lower ICH volumes (ß (95% Confidence Interval [CI]) − 0.30[− 0.46, − 0.14], − 0.33[− 0.49, − 0.17], − 0.40[− 0.60, − 0.20], and − 0.54[− 0.76, − 0.32], for grades 1, 2, 3 and 4 compared to 0; all P < 0.001). The associations of leukoaraiosis with ICH volume were consistent with those of atrophy, albeit not meeting statistical significance. 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.

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Section: Discussionmentioning

confidence: 99%

Section: Imaging Acquisition and Interpretationmentioning

confidence: 99%

Associations of Radiographic Cerebral Small Vessel Disease with Acute Intracerebral Hemorrhage Volume, Hematoma Expansion, and Intraventricular Hemorrhage

et al. 2019

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“…However, whether the timing and choose of the nutritional route (parenteral or enteral) in adults can reduce the adverse effect of malnutrition on the final recovery of patients is still object of debate and research. Another issue which deserves further investigation deals with the influence of genetic factors on the extent of functional recovery of patients: for instance, growing evidence suggests that specific genetic variations may influence the haematoma enlargement in acute intracerebral hemorrhage, thus affecting the risk of early death and later disability (39–41). Hopefully, in the future also genetic factors will be investigated to obtain even more tailored information on the chances of recovery of patients.…”

Section: Discussionmentioning

confidence: 99%

The Comorbidities Coma Scale (CoCoS): Psychometric Properties and Clinical Usefulness in Patients With Disorders of Consciousness

et al. 2019

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Although comorbidities have a well-known impact on the functional recovery of patients with disorders of consciousness, including coma, vegetative state (VS), and minimally conscious state (MCS), a specific tool for their assessment in this challenging group of patients is lacking. For this aim, a multistep process was used to develop and validate the Comorbidities Coma Scale (CoCoS) in a sample of 162 patients with a diagnosis of coma, VS or MCS admitted to four Acute Inpatient Rehabilitation Units. To establish the psychometric properties of the scale, content validity, and internal consistency were investigated through Exploratory Factor Analysis in the whole sample (n = 162). Interrater reliability, assessed by the weighted Cohen's kappa (Kw), and concurrent validity of the scale as compared to the Greenfield Scale, assessed by ρ Spearman's correlation coefficient, were investigated in a subsample of patients (n = 52) within two of the above units. Our findings provided evidence of a good content validity of the scale, with the identification of a 12-factor structure representing the different comorbid dimensions of the target population. Inter-rater reliability was excellent in both the rehabilitation units where the assessment was made [Kw 0.98 (95% CI 0.96–0.99)]. CoCoS total scores correlated significantly with total scores of the Greenfield Scale (ρ = 0.932, 95% CI 0.89–0.96; P < 0.0001) indicating that CoCoS has concurrent validity while being more informative about the specific pattern of comorbidities of these challenging patients. The CoCos is a new tool which standardizes the approach to assessment of comorbid conditions and reliably identifies the category and severity of each comorbidity detected. It may be used for both clinical and research applications.

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“…Elevated BHV scores usually lead to a decreased level of consciousness as a result of increased intracranial pressure, and this condition is associated with a poor prognosis 9 and low GOS score. 35 , 36 Indeed, BHV was considered more important than GCS in determining the treatment option in patients with ICH. 37 Additionally, a large BHV was demonstrated to be associated with elevated blood pressure, 38 and hypertension was shown to correlate with ACE G2350A gene polymorphisms.…”

Section: Discussionmentioning

confidence: 99%

Association of angiotensin-converting enzyme G2350A gene polymorphisms with hypertension among patients with intracerebral haemorrhage

Imran

Syahrul

Sofia

et al. 2019

Journal of Taibah University Medical Sciences

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Objectives To evaluate the correlation of angiotensin-converting enzyme (ACE) G2350A gene polymorphisms with hypertension, brain hematoma volume (BHV), level of consciousness, and disease outcome among intracerebral haemorrhage (ICH) patients. Methods A cross-sectional study was conducted in Zainoel Abidin General Hospital from May 2016 to June 2017. Polymerase chain reaction was used to genotype ACE G2350A gene polymorphisms. BHV was assessed using the ABC/2 volume estimation formula. Level of consciousness was assessed by Glasgow coma scale (GCS). Disease outcome was assessed using Glasgow outcome scale (GOS). Association tests for ACE G2350A genotype in the context of hypertension status, BHV, GCS score, and GOS score in subjects with ICH was analysed by multiple logistic regression. Results A total of 75 ICH patients were included in the study. Of those, 59 patients exhibited hypertension, 24 patients had BHV ≥60 cm 3 , 16 patients possessed GCS scores ≤8, and 72 patients had GOS scores of 1–3. Our analysis determined that the A allele of the ACE G2350A gene polymorphism was significantly associated with a 3.6-fold increase in hypertension; however, this polymorphism was not associated with BHV, level of consciousness, and disease outcome among ICH patients. Conclusion The A allele of the ACE G2350A gene polymorphisms is associated with hypertension among ICH patients.

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17p12 Influences Hematoma Volume and Outcome in Spontaneous Intracerebral Hemorrhage

Abstract: We identified as a novel susceptibility risk locus for hematoma volume, clinical severity, and functional outcome in nonlobar ICH. Replication in other ethnicities and follow-up translational studies are needed to elucidate the mechanism mediating the observed association.

Cited by 28 publications

References 51 publications

Associations of Radiographic Cerebral Small Vessel Disease with Acute Intracerebral Hemorrhage Volume, Hematoma Expansion, and Intraventricular Hemorrhage

Associations of Radiographic Cerebral Small Vessel Disease with Acute Intracerebral Hemorrhage Volume, Hematoma Expansion, and Intraventricular Hemorrhage

The Comorbidities Coma Scale (CoCoS): Psychometric Properties and Clinical Usefulness in Patients With Disorders of Consciousness

Association of angiotensin-converting enzyme G2350A gene polymorphisms with hypertension among patients with intracerebral haemorrhage

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