Lobar intracerebral hemorrhage: etiology and a long-term follow-up study of 32 patients.

Tanaka, Yutaka; Furuse, Motomasa; Iwasa, Hitomi; Masuzawa, Toshio; Saito, Kei; Sato, Fumiaki; Mizuno, Y

doi:10.1161/01.str.17.1.51

Cited by 38 publications

(19 citation statements)

References 21 publications

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“…The frequency of hypertension among patients with lobar ICH was reported to range from 20.0% to 47.5% in the 1980's (Table 6) (1,(15)(16)(17)(18). The frequency of hypertension in lobar ICH (60.0%) in the present study was higher than previously reported.…”

Section: Discussioncontrasting

confidence: 63%

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Clinical and Radiographic Features of Lobar Cerebral Hemorrhage: Hypertensive Versus Non-hypertensive Cases

et al. 2003

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ObjectivesThe underlying cause of lobar intracerebral hemorrhage (ICH) is often difficult to determine, since these vascular abnormalities are not necessarily visualized in radiographic studies. Wesought to determine the clinical features of hypertensive and nonhypertensive lobar ICH, and further predict the presence or absence of vascular abnormalities in terms of clinical features and radiographic abnormalities.Patients and Methods Eighty-one patients with lobar ICH were retrospectively assigned to either hypertensive or non-hypertensive groups based on their blood pressure levels during the chronic phase or a history of antihypertensive medication. The clinical and radiographic features of these two groups were compared.Results Forty-nine patients (60%) were hypertensive, and the other thirty-two (40%) were non-hypertensive.In the non-hypertensive group, amyloid angiopathy (n= 6), aneurysms (n=5), arteriovenous malformation (n=4), use of anticoagulants (n=2), liver cirrhosis (n=2) and thrombasthenia (n=l) were found as underlying causes.There were no significant differences between these two groups in the frequencies of stroke risk factors except for hypertension, clinical features and initial neurological findings. On the contrary, subarachnoid extension of the hematomaon CT was significantly more frequent in the non-hypertensive lobar ICH group than in the hypertensive group (p<0.001). The patients with subarachnoid extension were morelikely to have vascular abnormality than those without subarachnoid extension (p<0.01). Conclusion Subarachnoid extension of the hematoma on CTstrongly indicates a non-hypertensive cause, and more specifically, it suggests lobar ICH caused by vascular abnormalities.

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Section: Discussioncontrasting

confidence: 63%

“…The most frequent site was the parietal lobe as reported by Weisberg (16), the occipital lobe by Ropper and Davis (15), the temporoparietal lobes by Kase et al (1), and the temporal or temporoparietal lobes by Tanaka et al (17). In the study by Massaro et al, lobar ICHconfined to one lobe was observed most frequently in the frontal lobe.…”

Section: Discussionmentioning

confidence: 73%

Clinical and Radiographic Features of Lobar Cerebral Hemorrhage: Hypertensive Versus Non-hypertensive Cases

et al. 2003

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“…This finding is similar to that of previously reported series. 6,9,[11][12][13]15 The most common location of ICH resulting from arteriovenous malformations was lobar. Cavernous angioma was most commonly located supratentorially but was the most common cause of ICH located in the brain stem.…”

Section: Discussionmentioning

confidence: 99%

Intracerebral Hemorrhage in Young People

Ruiz-Sandoval

Cantú

Barinagarrementería

1999

Stroke

202

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Background and Purpose-The frequency of intracerebral hemorrhages (ICHs) in people aged Յ40 years has been poorly studied. We investigated the incidence, causes, locations, and prognosis of ICH in young patients. Methods-We evaluated all consecutive patients with neuroimaging evidence or pathological confirmation of symptomatic ICH. We excluded patients with primary subarachnoid or traumatic hemorrhage, past evidence of vascular malformation, or brain tumor. We analyzed the risk factors, number, locations, and causes of ICH, and final outcome measured by the modified Glasgow Outcome Scale. Results-We retrospectively evaluated 200 patients (mean age, 27 years; range, 15 to 40 years). The most frequent risk factors were tobacco use (20%), hypocholesterolemia (35%), hypertension, (13%), and alcohol use (10%). The locations of ICH were lobar (55%), basal ganglia/internal capsule (22%), and others (24%). The most common causes of ICH were vascular malformations (49%), including cavernous angioma, and hypertension (11%). Cryptogenic ICH was considered in 15%. Other causes included cerebral venous thrombosis (5%) and sympathomimetic drug use (4%). The majority of patients with ICH that resulted from hypertension were aged Ͼ31 years (odds ratio, 3.48), and those with ICH that resulted from arteriovenous malformations were aged Ͻ20 years (odds ratio, 2.80). The final outcome was considered favorable in 60%. Conclusions-ICHs

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“…3,7,28,29 One study reported that this association is more significant with lobar ICH. 30 Many studies have reported a high rate of hypertension among cases of ICH, 8,[31][32][33][34][35] and several reported that the rate was not significantly different by location of ICH. 24,35 Few studies have controlled for the presence of other risk factors and demographic variables that may affect the rate of hypertension.…”

Section: Lobar Ichmentioning

confidence: 99%

Genetic and Environmental Risk Factors for Intracerebral Hemorrhage

Woo

Sauerbeck

Kissela

et al. 2002

Stroke

393

296

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Background and Purpose-Intracerebral hemorrhage (ICH) has a 30-day mortality rate of 40% to 50% and lacks a proven treatment. We report a preplanned, midpoint analysis of the first population-based, case-control study that examines both genetic and environmental risk factors of ICH. Methods-We prospectively identified cases of hemorrhagic stroke at all 16 hospitals in the Greater Cincinnati/Northern Kentucky region. All cases underwent medical record and neuroimaging review. Cases enrolled in the direct interview and genetic sampling arm of the study were matched to population-based control subjects by age, race, and sex. Multivariable logistic regression was performed to identify significant independent risk factors. Results-We enrolled 188 cases of ICH (67 lobar, 121 nonlobar) and 366 control subjects in the direct interview arm of the study. Significant independent risk factors for lobar ICH included the presence of an apolipoprotein E2 or E4 allele, frequent alcohol use, prior stroke, and first-degree relative with ICH. Significant independent risk factors for nonlobar ICH were hypertension, prior stroke, and first-degree relative with ICH. An increasing level of education was associated with a decreased risk of nonlobar ICH. The attributable risk of apolipoprotein E2 or E4 for lobar ICH was 29%, and the attributable risk of hypertension for nonlobar ICH was 54%. Conclusions-There is significant epidemiological evidence that the pathophysiology of ICH varies by location. We estimate that a third of all cases of lobar ICH are attributable to possession of an apolipoprotein E4 or E2 allele and that half of all cases of nonlobar ICH are attributable to hypertension.

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Lobar intracerebral hemorrhage: etiology and a long-term follow-up study of 32 patients.

Cited by 38 publications

References 21 publications

Clinical and Radiographic Features of Lobar Cerebral Hemorrhage: Hypertensive Versus Non-hypertensive Cases

Clinical and Radiographic Features of Lobar Cerebral Hemorrhage: Hypertensive Versus Non-hypertensive Cases

Intracerebral Hemorrhage in Young People

Genetic and Environmental Risk Factors for Intracerebral Hemorrhage

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