Improving detection of cerebral small vessel disease aetiology in patients with isolated lobar intracerebral haemorrhage

作     者：Alvin S Das Elif Gokcal Robert W Regenhardt Mitchell J Horn Kristin Schwab Nader Daoud Anand Viswanathan W Taylor Kimberly Joshua N Goldstein Alessandro Biffi Natalia Rost Jonathan Rosand Lee H Schwamm Steven M Greenberg M Edip Gurol 

作者机构：Department of NeurologyBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA Department of NeurosurgeryMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA Department of Emergency MedicineMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA 

出 版 物：《Stroke & Vascular Neurology》 (卒中与血管神经病学（英文）)

年 卷 期：2023年第8卷第1期

页      面：26-33页

核心收录：

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

基　　金：the Andrew David Heitman Young Investigator Fund(grant numbers:R25NS065743 and R01NS11452) 

主　　题：patients cerebral hypertensive 

摘      要：Background and purpose We evaluate whether non-haemorrhagic imaging markers(NHIM)(white matter hyperintensity patterns,lacunes and enlarged perivascular spaces(EPVS))can discriminate cerebral amyloid angiopathy(CAA)from hypertensive cerebral small vessel disease(HTN-cSVD)among patients with isolated lobar intracerebral haemorrhage(isolated-LICH).Methods In patients with isolated-LICH,four cSVD aetiologic groups were created by incorporating the presence/distribution of NHIM:HTN-cSVD pattern,CAA pattern,mixed NHIM and no *** pattern consisted of patients with any combination of severe centrum semiovale EPVS,lobar lacunes or multiple subcortical spots ***-cSVD pattern consisted of any HTN-cSVD markers:severe basal ganglia PVS,deep lacunes or peribasal ganglia white matter hyperintensity *** NHIM consisted of at least one imaging marker from either *** hypothesis was that patients with HTN-cSVD pattern/mixed NHIM would have a higher frequency of left ventricular hypertrophy(LVH),which is associated with *** In 261 patients with isolated-LICH,CAA pattern was diagnosed in 93 patients,HTN-cSVD pattern in 53 patients,mixed NHIM in 19 patients and no NHIM in 96 *** frequency of LVH was similar among those with HTN-cSVD pattern and mixed NHIM(50%vs 39%,p=0.418)but was more frequent in HTN-cSVD pattern compared with CAA pattern(50%vs 20%,p0.001).In a regression model,HTN-cSVD pattern(OR:7.38;95%CI 2.84 to 19.20)and mixed NHIM(OR:4.45;95%CI 1.25 to 15.90)were found to be independently associated with *** Among patients with isolated-LICH,NHIM may help differentiate HTN-cSVD from CAA,using LVH as a marker for HTN-cSVD.