A Causal Classification System for Intracerebral Hemorrhage Subtypes

作者全名："Raposo, Nicolas; Zotin, Maria Clara Zanon; Seiffge, David J.; Li, Qi; Goeldlin, Martina B.; Charidimou, Andreas; Shoamanesh, Ashkan; Jager, Hans Rolf; Cordonnier, Charlotte; Klijn, Catharina Jm; Smith, Eric E.; Greenberg, Steven M.; Werring, David J.; Viswanathan, Anand"

作者地址："[Raposo, Nicolas] Toulouse Univ Hosp, Dept Neurol, Toulouse, France; [Raposo, Nicolas] Toulouse Univ, Toulouse Neurolmaging Ctr, Toulouse, France; [Zotin, Maria Clara Zanon; Charidimou, Andreas; Greenberg, Steven M.; Viswanathan, Anand] Harvard Med Sch, Stroke Res Ctr, Massachusetts Gen Hosp, Boston, MA 02115 USA; [Zotin, Maria Clara Zanon] Univ Sao Paulo, Ctr Imaging Sci & Med Phys, Dept Med Imaging Hematol & Clin Oncol, Ribeirao Preto Med Sch, Sao Paulo, Brazil; [Seiffge, David J.; Goeldlin, Martina B.] Univ Bern, Bern Univ Hosp, Dept Neurol, Inselspital, Bern, Switzerland; [Li, Qi] Chongqing Med Univ, Dept Neurol, Affiliated Hosp 1, Chongqing, Peoples R China; [Goeldlin, Martina B.] Univ Bern, Grad Sch Hlth Sci, Bern, Switzerland; [Shoamanesh, Ashkan] McMaster Univ, Populat Hlth Res Inst, Div Neurol, Hamilton, ON, Canada; [Jager, Hans Rolf; Werring, David J.] UCL Queen Sq Inst Neurol, Dept Brain Repair & Rehabil, Stroke Res Ctr, London, England; [Cordonnier, Charlotte] Univ Lille, U1172 LilNCog Lille Neurosci & Cognit, CHU Lille, INSERM, Lille, France; [Klijn, Catharina Jm] Radboud Univ Nijmegen, Med Ctr, Dept Neurol, Donders Inst Brain Cognit & Behav, Nijmegen, Netherlands; [Smith, Eric E.] Univ Calgary, Hotchkiss Brain Inst, Dept Clin Neurosci, Calgary, AB, Canada"

通信作者："Raposo, N (通讯作者)，Ctr Hosp Univ Toulouse, Serv Neurol, Hop Pierre Paul Riquet, Pl Baylac, F-31059 Toulouse 9, France."

来源：ANNALS OF NEUROLOGY

ESI学科分类：NEUROSCIENCE & BEHAVIOR

WOS号：WOS:000884325100001

JCR分区：Q1

影响因子：11.2

年份：2023

卷号：93

期号：1

开始页：16

结束页：28

文献类型：Article

关键词：　

摘要："Objective Determining the underlying causes of intracerebral hemorrhage (ICH) is of major importance, because risk factors, prognosis, and management differ by ICH subtype. We developed a new causal CLASsification system for ICH Subtypes, termed CLAS-ICH, based on recent advances in neuroimaging. Methods CLAS-ICH defines 5 ICH subtypes: arteriolosclerosis, cerebral amyloid angiopathy, mixed small vessel disease (SVD), other rare forms of SVD (genetic SVD and others), and secondary causes (macrovascular causes, tumor, and other rare causes). Every patient is scored in each category according to the level of diagnostic evidence: (1) well-defined ICH subtype; (2) possible underlying disease; and (0) no evidence of the disease. We evaluated CLAS-ICH in a derivation cohort of 113 patients with ICH from Massachusetts General Hospital, Boston, USA, and in a derivation cohort of 203 patients from Inselspital, Bern, Switzerland. Results In the derivation cohort, a well-defined ICH subtype could be identified in 74 (65.5%) patients, including 24 (21.2%) with arteriolosclerosis, 23 (20.4%) with cerebral amyloid angiopathy, 18 (15.9%) with mixed SVD, and 9 (8.0%) with a secondary cause. One or more possible causes were identified in 42 (37.2%) patients. Interobserver agreement was excellent for each category (kappa value ranging from 0.86 to 1.00). Despite substantial differences in imaging modalities, we obtained similar results in the validation cohort. Interpretation CLAS-ICH is a simple and reliable classification system for ICH subtyping, that captures overlap between causes and the level of diagnostic evidence. CLAS-ICH may guide clinicians to identify ICH causes, and improve ICH classification in multicenter studies. ANN NEUROL 2022"

基金机构："NIH [P50 AG005134, R01 AG047975, R01 NS104130]"

基金资助正文："The authors thank Andrew D. Warren for expert technical assistance. This study was supported by the following NIH grants: P50 AG005134, R01 AG047975, R01 NS104130. Open Access funding enabled and organized by Projekt DEAL."