Sykora Marek, Herweh Christian, Steiner Thorsten
Department of Neurology, Heidelberg University, Germany; Department of Neurocritical Care, Sigmund Freud Privatuniversität, Vienna, Austria.
Department of Neuroradiology, Heidelberg University, Germany.
J Stroke Cerebrovasc Dis. 2017 Jun;26(6):1328-1333. doi: 10.1016/j.jstrokecerebrovasdis.2017.02.003. Epub 2017 Feb 23.
The significance of white matter lesions (WMLs) in intracerebral hemorrhage (ICH) remains unclear. We investigated the effects of WML on initial hematoma volume, hematoma growth, intraventricular extension, and clinical outcome in patients with spontaneous ICH.
Computed tomography scans of 262 patients included in a placebo arm of a prospective, multicenter trial were used for a semi-quantitative analysis of white matter changes. A logistic regression analysis was used to explore the effects on hematoma volume, volume changes, intraventricular hemorrhage, and clinical outcome after 90 days.
The degree of WML was not associated with initial hematoma volume, absolute and relative hematoma growth, hematoma growth >33% or >6 mL, or with intraventricular extension. WML significantly increased the odds for poor outcome after 90 days (adjusted OR 1.4, 95% CI 1.1-1.8, P = .02).
WMLs were not associated with initial hematoma volume, hematoma growth, or intraventricular extension. WMLs were associated with poor outcome independently.
脑内出血（ICH）中白质病变（WMLs）的意义仍不明确。我们研究了WML对自发性ICH患者初始血肿体积、血肿扩大、脑室扩展及临床结局的影响。
对一项前瞻性多中心试验安慰剂组纳入的262例患者的计算机断层扫描进行白质变化的半定量分析。采用逻辑回归分析探讨其对血肿体积、体积变化、脑室内出血及90天后临床结局的影响。
WML程度与初始血肿体积、绝对和相对血肿扩大、血肿扩大>33%或>6 mL以及脑室扩展均无关。WML显著增加了90天后不良结局的几率（校正比值比1.4，95%可信区间1.1 - 1.8，P = 0.02）。
WML与初始血肿体积、血肿扩大或脑室扩展无关。WML独立与不良结局相关。
