White Matter Lesion Severity is Associated with Intraventricular Hemorrhage in Spontaneous Intracerebral Hemorrhage

Vagal, Vaibhav; Venema, Simone Uniken; Behymer, Tyler P; Mistry, Eva; Sekar, Padmini; Sawyer, Russell P.; Gilkerson, Lee; Moomaw, Charles J.; Haverbusch, Mary; Coleman, Elisheva; Flaherty, Matthew L.; Sanford, Carson Van; Stanton, Robert J.; Anderson, Christopher; Rosand, Jonathan; Woo, Daniel

doi:10.1016/j.jstrokecerebrovasdis.2020.104661

Cited by 5 publications

(5 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, we excluded patients with lobar ICH, which limits the generalizability of our results. Third, a previous study reported that the risk factors of IVH after ICH include the location and volume of hematoma, baseline arterial pressure, and moderate-to-severe white matter lesions ( 4 - 9 ). In our study, the multivariate analysis indicated that SI and LMA were significantly associated with IVH after adjustments were made for age, hematoma location, and baseline arterial pressure.…”

Section: Discussionmentioning

confidence: 99%

“…Understanding the risk factors and pathophysiology of IVH may help to identify optimal therapeutic strategies. Multiple risk factors contributing to IVH after ICH, including the location and volume of hematoma, baseline arterial pressure, and moderate to severe white matter lesions, have been identified ( 4 - 9 ). Compared with lobar ICH, deep ICH involves an anatomical juxtaposition with the ventricles which makes them highly prevalent areas of IVH.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The relationship between hematoma morphology and intraventricular hemorrhage in supratentorial deep intracerebral hemorrhage

Li,

Zhang,

et al. 2023

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background Intraventricular hemorrhage (IVH) after intracerebral hemorrhage (ICH) is a strong independent predictor of poor outcomes. Although the location and volume of ICH are associated with IVH, our knowledge concerning the mechanism of IVH after ICH is still limited. This study aimed to investigate the relationship between hematoma morphology and IVH in patients with supratentorial deep ICH. Methods We retrospectively analyzed adult patients (aged ≥18 years) with spontaneous supratentorial deep ICH who underwent computed tomography (CT) within 48 h after ICH symptom onset in Peking University First Hospital between January 2017 and August 2022. We collected the clinical and imaging data of the patients and assessed hematoma morphology using several quantitative radiological parameters including hematoma volume, sphericity index, A/B ratio (A: the largest area of hematoma; B: the largest diameter 90° to A on the same slice), and our newly proposed largest diameter-midline angle (LMA). Multivariable logistic regression analysis was used to analyze the relationship between these parameters and the presence of IVH on the initial CT scan. Results Among 114 patients with spontaneous supratentorial deep ICH, 41 (36.0%) had IVH. In patients with IVH, the sphericity index was lower than that in individuals without IVH, while the LMA was larger. Multivariate logistic regression analysis showed that sphericity index [0.1-unit odds ratio (OR) =0.252; 95% CI: 0.089–0.709; P=0.009] and the LMA (10-unit OR =1.281; 95% CI: 1.007–1.630; P=0.04) were independently associated with the presence of IVH in patients with supratentorial deep ICH. Univariate analyses showed that hematoma volume, A/B ratio, sphericity index, and the LMA were significantly associated with poor outcomes at discharge. Conclusions Two quantitative parameters of hematoma morphology, sphericity index and the LMA, were significantly associated with the presence of IVH in patients with supratentorial deep ICH. Further prospective studies with larger sample sizes are needed to validate our results.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The relationship between hematoma morphology and intraventricular hemorrhage in supratentorial deep intracerebral hemorrhage

Li,

Zhang,

et al. 2023

Quant Imaging Med Surg

View full text Add to dashboard Cite

show abstract

“…Second, sTWEAK measurements were not simultaneous and were made by different researchers, although measurements were always blind to the clinical and neuroradiological data and supervised by the same senior researchers, and the same is true of clinical and neuroradiological data. Three, it is important to note that LA is a gradual disease affected by different risk factors, and not associated with a unique pathological process ( 16 , 50 ). There is the possibility that LA may be associated with factors in the study population other than stroke.…”

Section: Discussionmentioning

confidence: 99%

sTWEAK as Predictor of Stroke Recurrence in Ischemic Stroke Patients Treated With Reperfusion Therapies

et al. 2021

View full text Add to dashboard Cite

Aim: The purpose of this study was to investigate clinical and neuroimaging factors associated with stroke recurrence in reperfused ischemic stroke patients, as well as the influence of specific biomarkers of inflammation and endothelial dysfunction.Methods: We conducted a retrospective analysis on a prospectively registered database. Of the 875 patients eligible for this study (53.9% males; mean age 69.6 ± 11.8 years vs. 46.1% females; mean age 74.9 ± 12.6 years), 710 underwent systemic thrombolysis, 87 thrombectomy and in 78, systemic or intra-arterial thrombolysis together with thrombectomy was applied. Plasma levels of interleukin 6 (IL-6) and tumor necrosis factor alpha (TNFα) were analyzed as markers of inflammation, and soluble tumor necrosis factor-like inducer of apoptosis (sTWEAK) as an endothelial dysfunction marker. The main outcome variables of the study were the presence and severity of leukoaraiosis (LA) and stroke recurrence.Results: The average follow-up time of the study was 25 ± 13 months, during which 127 patients (14.5%) showed stroke recurrence. The presence and severity of LA was more severe in the second stroke episode (Grade III of the Fazekas 28.3 vs. 52.8%; p < 0.0001). IL-6 levels at the first admission and before reperfusion treatment in patients with and without subsequent recurrence were similar (9.9 ± 10.4 vs. 9.1 ± 7.0 pg/mL, p = 0.439), but different for TNFα (14.7 ± 5.6 vs. 15.9 ± 5.7 pg/mL, p = 0.031) and sTWEAK (5,970.8 ± 4,330.4 vs. 8,660.7 ± 5,119.0 pg/mL, p < 0.0001). sTWEAK values ≥7,000 pg/mL determined in the first stroke were independently associated to recurrence (OR 2.79; CI 95%: 1.87–4.16, p < 0.0001).Conclusions: The severity and the progression of LA are the main neuroimaging factors associated with stroke recurrence. Likewise, sTWEAK levels were independently associated to stroke recurrence, so further studies are necessary to investigate sTWEAK as a therapeutic target.

show abstract

“…Leukoaraiosis has been related to chronic and subclinical cerebral hypoxia-ischemia associated with BBB dysfunction [ 126 , 188 , 189 , 190 , 191 , 192 ]. The clinical importance of this neuroimaging marker is that its prevalence affects 70% of adults over 65 years of age, especially women [ 191 ], and that its presence multiplies the risk of stroke by three, the risk of dementia by two [ 189 ], and the risk of intraventricular haemorrhage by one and thirty-eight hundredths [ 193 ]. We have also verified that the volume of leukoaraiosis has a direct relationship with the risk of developing clinical manifestations (from 1.7 times more frequent with grade I leukoaraiosis on the Fazecas scale [ 194 ], up to 4.7 times in those with grade III) [ 157 ].…”

Section: Evolution Of Bbb Dysfunction In the Setting Of Ischemic Strokementioning

confidence: 99%

Need for a Paradigm Shift in the Treatment of Ischemic Stroke: The Blood-Brain Barrier

Alonso-Alonso¹,

Sampedro-Viana²,

Fernández-Rodicio³

et al. 2022

IJMS

View full text Add to dashboard Cite

Blood-brain barrier (BBB) integrity is essential to maintaining brain health. Aging-related alterations could lead to chronic progressive leakiness of the BBB, which is directly correlated with cerebrovascular diseases. Indeed, the BBB breakdown during acute ischemic stroke is critical. It remains unclear, however, whether BBB dysfunction is one of the first events that leads to brain disease or a down-stream consequence. This review will focus on the BBB dysfunction associated with cerebrovascular disease. An added difficulty is its association with the deleterious or reparative effect, which depends on the stroke phase. We will first outline the BBB structure and function. Then, we will focus on the spatiotemporal chronic, slow, and progressive BBB alteration related to ischemic stroke. Finally, we will propose a new perspective on preventive therapeutic strategies associated with brain aging based on targeting specific components of the BBB. Understanding BBB age-evolutions will be beneficial for new drug development and the identification of the best performance window times. This could have a direct impact on clinical translation and personalised medicine.

show abstract

White Matter Lesion Severity is Associated with Intraventricular Hemorrhage in Spontaneous Intracerebral Hemorrhage

Cited by 5 publications

References 27 publications

The relationship between hematoma morphology and intraventricular hemorrhage in supratentorial deep intracerebral hemorrhage

The relationship between hematoma morphology and intraventricular hemorrhage in supratentorial deep intracerebral hemorrhage

sTWEAK as Predictor of Stroke Recurrence in Ischemic Stroke Patients Treated With Reperfusion Therapies

Need for a Paradigm Shift in the Treatment of Ischemic Stroke: The Blood-Brain Barrier

Contact Info

Product

Resources

About