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 

机构地区：[1]Department of Neurology,Beth Israel Deaconess Medical Center,Harvard Medical School,Boston,Massachusetts,USA [2]Department of Neurology,Massachusetts General Hospital,Harvard Medical School,Boston,Massachusetts,USA [3]Department of Neurosurgery,Massachusetts General Hospital,Harvard Medical School,Boston,Massachusetts,USA [4]Department of Emergency Medicine,Massachusetts General Hospital,Harvard Medical School,Boston,Massachusetts,USA

出　　处：《Stroke & Vascular Neurology》2023年第1期26-33,共8页卒中与血管神经病学（英文）

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

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 NHIM.CAA pattern consisted of patients with any combination of severe centrum semiovale EPVS,lobar lacunes or multiple subcortical spots pattern.HTN-cSVD pattern consisted of any HTN-cSVD markers:severe basal ganglia PVS,deep lacunes or peribasal ganglia white matter hyperintensity pattern.Mixed NHIM consisted of at least one imaging marker from either pattern.Our hypothesis was that patients with HTN-cSVD pattern/mixed NHIM would have a higher frequency of left ventricular hypertrophy(LVH),which is associated with HTN-cSVD.Results 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 patients.The 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%,p<0.001).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 LVH.Conclusion Among patients with isolated-LICH,NHIM may help differentiate HTN-cSVD from CAA,using LVH as a marker for HTN-cSVD.

关 键 词：PATIENTS CEREBRAL HYPERTENSIVE 

分 类 号：R743.34[医药卫生—神经病学与精神病学]