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Cortical superficial siderosis predicts early recurrent lobar hemorrhage.
Roongpiboonsopit, Duangnapa; Charidimou, Andreas; William, Christopher M; Lauer, Arne; Falcone, Guido J; Martinez-Ramirez, Sergi; Biffi, Alessandro; Ayres, Alison; Vashkevich, Anastasia; Awosika, Oluwole O; Rosand, Jonathan; Gurol, M Edip; Silverman, Scott B; Greenberg, Steven M; Viswanathan, Anand.
Afiliação
  • Roongpiboonsopit D; From The Hemorrhagic Stroke Research Program, J. Philip Kistler Stroke Research Center (D.R., A.C., A.L., G.J.F., S.M.-R., A.A., A. Vashkevich, M.E.G., S.B.S., S.M.G., A. Viswanathan), and Division of Behavioral Neurology (A.B.), Department of Neurology, Division of Neuropsychiatry, Department of Ps
  • Charidimou A; From The Hemorrhagic Stroke Research Program, J. Philip Kistler Stroke Research Center (D.R., A.C., A.L., G.J.F., S.M.-R., A.A., A. Vashkevich, M.E.G., S.B.S., S.M.G., A. Viswanathan), and Division of Behavioral Neurology (A.B.), Department of Neurology, Division of Neuropsychiatry, Department of Ps
  • William CM; From The Hemorrhagic Stroke Research Program, J. Philip Kistler Stroke Research Center (D.R., A.C., A.L., G.J.F., S.M.-R., A.A., A. Vashkevich, M.E.G., S.B.S., S.M.G., A. Viswanathan), and Division of Behavioral Neurology (A.B.), Department of Neurology, Division of Neuropsychiatry, Department of Ps
  • Lauer A; From The Hemorrhagic Stroke Research Program, J. Philip Kistler Stroke Research Center (D.R., A.C., A.L., G.J.F., S.M.-R., A.A., A. Vashkevich, M.E.G., S.B.S., S.M.G., A. Viswanathan), and Division of Behavioral Neurology (A.B.), Department of Neurology, Division of Neuropsychiatry, Department of Ps
  • Falcone GJ; From The Hemorrhagic Stroke Research Program, J. Philip Kistler Stroke Research Center (D.R., A.C., A.L., G.J.F., S.M.-R., A.A., A. Vashkevich, M.E.G., S.B.S., S.M.G., A. Viswanathan), and Division of Behavioral Neurology (A.B.), Department of Neurology, Division of Neuropsychiatry, Department of Ps
  • Martinez-Ramirez S; From The Hemorrhagic Stroke Research Program, J. Philip Kistler Stroke Research Center (D.R., A.C., A.L., G.J.F., S.M.-R., A.A., A. Vashkevich, M.E.G., S.B.S., S.M.G., A. Viswanathan), and Division of Behavioral Neurology (A.B.), Department of Neurology, Division of Neuropsychiatry, Department of Ps
  • Biffi A; From The Hemorrhagic Stroke Research Program, J. Philip Kistler Stroke Research Center (D.R., A.C., A.L., G.J.F., S.M.-R., A.A., A. Vashkevich, M.E.G., S.B.S., S.M.G., A. Viswanathan), and Division of Behavioral Neurology (A.B.), Department of Neurology, Division of Neuropsychiatry, Department of Ps
  • Ayres A; From The Hemorrhagic Stroke Research Program, J. Philip Kistler Stroke Research Center (D.R., A.C., A.L., G.J.F., S.M.-R., A.A., A. Vashkevich, M.E.G., S.B.S., S.M.G., A. Viswanathan), and Division of Behavioral Neurology (A.B.), Department of Neurology, Division of Neuropsychiatry, Department of Ps
  • Vashkevich A; From The Hemorrhagic Stroke Research Program, J. Philip Kistler Stroke Research Center (D.R., A.C., A.L., G.J.F., S.M.-R., A.A., A. Vashkevich, M.E.G., S.B.S., S.M.G., A. Viswanathan), and Division of Behavioral Neurology (A.B.), Department of Neurology, Division of Neuropsychiatry, Department of Ps
  • Awosika OO; From The Hemorrhagic Stroke Research Program, J. Philip Kistler Stroke Research Center (D.R., A.C., A.L., G.J.F., S.M.-R., A.A., A. Vashkevich, M.E.G., S.B.S., S.M.G., A. Viswanathan), and Division of Behavioral Neurology (A.B.), Department of Neurology, Division of Neuropsychiatry, Department of Ps
  • Rosand J; From The Hemorrhagic Stroke Research Program, J. Philip Kistler Stroke Research Center (D.R., A.C., A.L., G.J.F., S.M.-R., A.A., A. Vashkevich, M.E.G., S.B.S., S.M.G., A. Viswanathan), and Division of Behavioral Neurology (A.B.), Department of Neurology, Division of Neuropsychiatry, Department of Ps
  • Gurol ME; From The Hemorrhagic Stroke Research Program, J. Philip Kistler Stroke Research Center (D.R., A.C., A.L., G.J.F., S.M.-R., A.A., A. Vashkevich, M.E.G., S.B.S., S.M.G., A. Viswanathan), and Division of Behavioral Neurology (A.B.), Department of Neurology, Division of Neuropsychiatry, Department of Ps
  • Silverman SB; From The Hemorrhagic Stroke Research Program, J. Philip Kistler Stroke Research Center (D.R., A.C., A.L., G.J.F., S.M.-R., A.A., A. Vashkevich, M.E.G., S.B.S., S.M.G., A. Viswanathan), and Division of Behavioral Neurology (A.B.), Department of Neurology, Division of Neuropsychiatry, Department of Ps
  • Greenberg SM; From The Hemorrhagic Stroke Research Program, J. Philip Kistler Stroke Research Center (D.R., A.C., A.L., G.J.F., S.M.-R., A.A., A. Vashkevich, M.E.G., S.B.S., S.M.G., A. Viswanathan), and Division of Behavioral Neurology (A.B.), Department of Neurology, Division of Neuropsychiatry, Department of Ps
  • Viswanathan A; From The Hemorrhagic Stroke Research Program, J. Philip Kistler Stroke Research Center (D.R., A.C., A.L., G.J.F., S.M.-R., A.A., A. Vashkevich, M.E.G., S.B.S., S.M.G., A. Viswanathan), and Division of Behavioral Neurology (A.B.), Department of Neurology, Division of Neuropsychiatry, Department of Ps
Neurology ; 87(18): 1863-1870, 2016 Nov 01.
Article em En | MEDLINE | ID: mdl-27694268
ABSTRACT

OBJECTIVE:

To identify predictors of early lobar intracerebral hemorrhage (ICH) recurrence, defined as a new ICH within 6 months of the index event, in patients with cerebral amyloid angiopathy (CAA).

METHODS:

Participants were consecutive survivors (age ≥55 years) of spontaneous symptomatic probable or possible CAA-related lobar ICH according to the Boston criteria, drawn from an ongoing single-center cohort study. Neuroimaging markers ascertained in CT or MRI included focal (≤3 sulci) or disseminated (>3 sulci) cortical superficial siderosis (cSS), acute convexity subarachnoid hemorrhage (cSAH), cerebral microbleeds, white matter hyperintensities burden and location, and baseline ICH volume. Participants were followed prospectively for recurrent symptomatic ICH. Cox proportional hazards models were used to identify predictors of early recurrent ICH adjusting for potential confounders.

RESULTS:

A total of 292 patients were enrolled. Twenty-one patients (7%) had early recurrent ICH. Of these, 24% had disseminated cSS on MRI and 19% had cSAH on CT scan. In univariable analysis, the presence of disseminated cSS, cSAH, and history of previous ICH were predictors of early recurrent ICH (p < 0.05 for all comparisons). After adjusting for age and history of previous ICH, disseminated cSS on MRI and cSAH on CT were independent predictors of early recurrent ICH (hazard ratio [HR] 3.92, 95% confidence interval [CI] 1.38-11.17, p = 0.011, and HR 3.48, 95% CI 1.13-10.73, p = 0.030, respectively).

CONCLUSIONS:

Disseminated cSS on MRI and cSAH on CT are independent imaging markers of increased risk for early recurrent ICH. These markers may provide additional insights into the mechanisms of ICH recurrence in patients with CAA.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Córtex Cerebral / Hemorragia Cerebral / Siderose Idioma: En Ano de publicação: 2016 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Córtex Cerebral / Hemorragia Cerebral / Siderose Idioma: En Ano de publicação: 2016 Tipo de documento: Article