CT-Visible Convexity Subarachnoid Hemorrhage is Associated With Cortical Superficial Siderosis and Predicts Recurrent ICH

作者全名："Li, Qi; Zotin, Maria Clara Zanon; Warren, Andrew D.; Ma, Yuan; Gurol, Edip; Goldstein, Joshua N.; Greenberg, Steven M.; Charidimou, Andreas; Raposo, Nicolas; Viswanathan, Anand"

作者地址："[Li, Qi; Zotin, Maria Clara Zanon; Warren, Andrew D.; Gurol, Edip; Greenberg, Steven M.; Charidimou, Andreas; Viswanathan, Anand] Harvard Med Sch, Massachusetts Gen Hosp, Dept Neurol, Boston, MA 02115 USA; [Goldstein, Joshua N.] Harvard Med Sch, Massachusetts Gen Hosp, Div Neurocrit Care & Emergency Neurol, Boston, MA 02115 USA; [Li, Qi] Chongqing Med Univ, Affiliated Hosp 1, Dept Neurol, Chongqing, Peoples R China; [Ma, Yuan] Harvard TH Chan Sch Publ Hlth, Dept Epidemiol, Boston, MA USA; [Raposo, Nicolas] CHU Toulouse, Hop Pierre Paul Riquet, Dept Neurol, Toulouse, France"

通信作者："Li, Q (corresponding author), Harvard Med Sch, Massachusetts Gen Hosp, Dept Neurol, Boston, MA 02115 USA.; Li, Q (corresponding author), Chongqing Med Univ, Affiliated Hosp 1, Dept Neurol, Chongqing, Peoples R China."

来源：NEUROLOGY

ESI学科分类：NEUROSCIENCE & BEHAVIOR

WOS号：WOS:000656635000017

JCR分区：Q1

影响因子：9.9

年份：2021

卷号：96

期号：7

开始页：E986

结束页：E994

文献类型：Article

关键词：　

摘要："Objective To investigate whether acute convexity subarachnoid hemorrhage (cSAH) detected on CT in lobar intracerebral hemorrhage (ICH) related to cerebral amyloid angiopathy (CAA) is associated with recurrent ICH. Methods We analyzed data from a prospective cohort of consecutive acute lobar ICH survivors fulfilling the Boston criteria for possible or probable CAA who had both brain CT and MRI at index ICH. Presence of cSAH was assessed on CT blinded to MRI data. Cortical superficial siderosis (cSS), cerebral microbleeds, and white matter hyperintensities were evaluated on MRI. Cox proportional hazard models were used to assess the association between cSAH and the risk of recurrent symptomatic ICH during follow-up. Results A total of 244 ICH survivors (76.4 +/- 8.7 years; 54.5% female) were included. cSAH was observed on baseline CT in 99 patients (40.5%). Presence of cSAH was independently associated with cSS, hematoma volume, and preexisting dementia. During a median follow-up of 2.66 years, 49 patients (20.0%) had recurrent symptomatic ICH. Presence of cSAH was associated with recurrent ICH (hazard ratio 2.64; 95% confidence interval 1.46-4.79; p = 0.001), after adjusting for age, antiplatelet use, warfarin use, and history of previous ICH. Conclusion cSAH was detected on CT in 40.5% of patients with acute lobar ICH related to CAA and heralds an increased risk of recurrent ICH. This CT marker may be widely used to stratify the ICH risk in patients with CAA. Classification of Evidence This study provides Class II evidence that cSAH accurately predicts recurrent stroke in patients with CAA."

基金机构："NIHUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA [R01AG047975, R01AG026484, R01 NS070834]; NIH StrokeNet fellowshipUnited States Department of Health & Human ServicesNational Institutes of Health (NIH) - USA"

基金资助正文："This study was supported by the following NIH grants: R01AG047975, R01AG026484, and R01 NS070834. Q. Li was supported by an NIH StrokeNet fellowship."