Combined effect of cortical superficial siderosis and cerebral microbleed on short-term and long-term outcomes after intracerebral haemorrhage  

作　　者：Yujia Jin Yu-hui Huang Yu-ping Chen Yao-dan Zhang Jiawen Li Kai-cheng Yang Xianghua Ye Lu-hang Jin Jian Wu Chang-zheng Yuan Feng Gao Lu-sha Tong 

机构地区：[1]Neurology Department,The Second Affiliated Hospital of Zhejiang University,School of Medicine,Hangzhou,China [2]School of Public Health,Zhejiang University,Hangzhou,China [3]Department of Neurology,Tiantai People's Hospital of Zhejiang Province,Taizhou,China

出　　处：《Stroke & Vascular Neurology》2024年第4期429-438,I0131-I0146,共26页卒中与血管神经病学（英文）

基　　金：supported by grants from National Natural Science Foundation of China(NSFC)81971155,81471168 and 81500991;the Science and Technology Department of Zhejiang Province(2022KY174);‘Leading Goose’R&D Program of Zhejiang(2023C03026).

摘　　要：Background and purpose Cortical superficial siderosis(cSS)and cerebral microbleed(CMB)have distinct effects on intracerebral haemorrhage(ICH).We aim to investigate the combined effect of cSS and CMB on outcomes after ICH.Methods Based on a single-centre stroke registry database,patients with spontaneous ICH who had CT scan within 48 hours after ictus and MRI subsequently were identified.Eligible patients were divided into four groups(cSS-CMB−,cSS-CMB+,cSS+CMB−,cSS+CMB+)according to cSS and CMB on susceptibility-weighted image of MRI.Primary outcomes were haematoma volume on admission and unfavourable outcome defined as modified Rankin Scale scores≥3 at 3 months.Secondary outcomes were all-cause death,recurrence of stroke and ICH during follow-up(median follow-up 2.0 years,IQR 1.0-3.0 years).Results A total of 673 patients were identified from 1044 patients with spontaneous ICH.131(19.5%)had cSS and 468(69.5%)had CMB.Patients with cSS+CMB+had the highest rate of poor outcome at 3 months,as well as all-cause death,recurrent stroke and ICH during follow-up.In cSS−patients,CMB was associated with smaller haematoma(β−0.13;95%CI−0.22 to−0.03;p=0.009),but it still increased risks of recurrent ICH(OR 4.6;95%CI 1.3 to 15.6;p=0.015)and stroke(OR 2.0;95%CI 1.0 to 4.0;p=0.049).These effects of CMB became unremarkable in the context of cSS+.Conclusions Patients with different combinations of cSS and CMB have distinct patterns of short-term and long-term outcomes.Although CMB is related to restrained haematoma,it does not improve long-term outcomes.

关 键 词：SUPERFICIAL CEREBRAL effect 

分 类 号：R743.34[医药卫生—神经病学与精神病学]