Measures of intracranial compartments in acute intracerebral haemorrhage:data from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial(RIGHT-2)  

作　　者：Kailash Krishnan Zhe Kang Law Lisa J Woodhouse Rob A Dineen Nikola Sprigg Joanna M Wardlaw Philip M Bath 

机构地区：[1]Stroke,Department of Acute Medicine,Nottingham University Hospitals NHS Trust,Nottingham,UK [2]Stroke Trials Unit,University of Nottingham,Nottingham,UK [3]Department of Medicine,National University of Malaysia Faculty of Medicine,Kuala Lumpur,Malaysia [4]Radiological Sciences Research Group,University of Nottingham,Nottingham,UK [5]National Institute of Health Research Nottingham Biomedical Research Centre,University of Nottingham,Nottingham,UK [6]Centre for Clinical Brain Sciences,UK Dementia Research Institute,Chancellor's Building,University of Edinburgh,Edinburgh,UK

出　　处：《Stroke & Vascular Neurology》2023年第2期151-160,共10页卒中与血管神经病学（英文）

基　　金：RIGHT-2(ISRCTN26986053);funded by the British Heart Foundation(grant number CS/14/4/30972).

摘　　要：Background and purpose Intracerebral haemorrhage volume(ICHV)is prognostically important but does not account for intracranial volume(ICV)and cerebral parenchymal volume(CPV).We assessed measures of intracranial compartments in acute ICH using computerised tomography scans and whether ICHV/ICV and ICHV/CPV predict functional outcomes.We also assessed if cistern effacement,midline shift,old infarcts,leukoaraiosis and brain atrophy were associated with outcomes.Methods Data from 133 participants from the Rapid Intervention with Glyceryl Trinitrate in Hypertensive Stroke-2 Trial trial were analysed.Measures included ICHV(using ABC/2)and ICV(XYZ/2)(by independent observers);ICHV,ICV and CPV(semiautomated segmentation,SAS);atrophy(intercaudate distance,ICD,Sylvian fissure ratio,SFR);midline shift;leukoaraiosis and cistern effacement(visual assessment).The effects of these measures on death at day 4 and poor functional outcome at day 90(modified Rankin scale,mRS of>3)was assessed.Results ICV was significantly different between XYZ and SAS:mean(SD)of 1357(219)vs 1420(196),mean difference(MD)62 mL(p<0.001).There was no significant difference in ICHV between ABC/2 and SAS.There was very good agreement for ICV measured by SAS,CPV,ICD,SFR,leukoaraiosis and cistern score(all interclass correlations,n=10:interobserver 0.72-0.99,intraobserver 0.73-1.00).ICHV/ICV and ICHV/CPV were significantly associated with mRS at day 90,death at day 4 and acute neurological deterioration(all p<0.05),similar to ICHV.Midline shift and cistern effacement at baseline were associated with poor functional outcome but old infarcts,leukoaraiosis and brain atrophy were not.Conclusions Intracranial compartment measures and visual estimates are reproducible.ICHV adjusted for ICH and CPV could be useful to prognosticate in acute stroke.The presence of midline shift and cistern effacement may predict outcome but the mechanisms need validation in larger studies.

关 键 词：measures Tri NITRATE 

分 类 号：R743.34[医药卫生—神经病学与精神病学]