Stroke Research Centre, University College London, Institute of Neurology, London, UK; Neurologia and Stroke Unit ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Stroke Research Centre, University College London, Institute of Neurology, London, UK.
J Neurol Sci. 2022 Mar 15;434:120165. doi: 10.1016/j.jns.2022.120165. Epub 2022 Jan 24.
INTRODUCTION: Total small vessel disease (SVD) score and cerebral amyloid angiopathy (CAA) score are magnetic resonance imaging-based composite scores built to preferentially capture deep perforator arteriopathy-related and CAA-related SVD burden, respectively. Non-lobar intracerebral haemorrhage (ICH) is related to deep perforator arteriopathy, while lobar ICH can be associated with deep perforator arteriopathy or CAA; however, the associations between ICH location and these scores are not established. METHODS: In this post-hoc analysis from a prospective cohort study, we included 153 spontaneous non-cerebellar ICH patients. Wald test, univariable and multivariable logistic regression analysis were performed to investigate the association between each score (and individual score components) and ICH location. RESULTS: Total SVD score was associated with non-lobar ICH location (Wald test: unadjusted, p = 0.017; adjusted, p = 0.003); however, no individual component of total SVD score was significantly associated with non-lobar ICH. CAA score was not significantly associated with lobar location (Wald test: unadjusted, p = 0.056; adjusted, p = 0.126); cortical superficial siderosis (OR 8.85 [95%CI 1.23-63.65], p = 0.030) and ≥ 2 strictly lobar microbleeds (OR 1.63 [95%CI 1.04-2.55], p = 0.035) were related with lobar ICH location, while white matter hyperintensities showed an inverse relation (OR 0.53 [95%CI 0.26-1.08; p = 0.081]). CONCLUSIONS: Total SVD score was associated with non-lobar ICH location. The lack of significant association between CAA score and lobar ICH may in part be due to the mixed aetiology of lobar ICH, and to the inclusion of white matter hyperintensities, a non-specific marker of SVD type, in the CAA score.
简介:总小血管疾病(SVD)评分和脑淀粉样血管病(CAA)评分是基于磁共振成像的综合评分,分别用于优先捕获深穿支动脉病变相关和 CAA 相关 SVD 负担。非叶性脑内出血(ICH)与深穿支动脉病变有关,而叶性 ICH 可与深穿支动脉病变或 CAA 相关;然而,ICH 部位与这些评分之间的关系尚未确定。
方法:在一项前瞻性队列研究的事后分析中,我们纳入了 153 例自发性非小脑 ICH 患者。采用 Wald 检验、单变量和多变量逻辑回归分析,探讨各评分(及各评分成分)与 ICH 部位之间的关系。
结果:总 SVD 评分与非叶性 ICH 部位相关(Wald 检验:未校正,p=0.017;校正后,p=0.003);然而,总 SVD 评分的各个成分与非叶性 ICH 均无显著相关性。CAA 评分与叶性部位无显著相关性(Wald 检验:未校正,p=0.056;校正后,p=0.126);皮质浅层铁质沉着症(OR 8.85[95%CI 1.23-63.65],p=0.030)和≥2 个严格的叶性微出血(OR 1.63[95%CI 1.04-2.55],p=0.035)与叶性 ICH 部位相关,而脑白质高信号呈反比关系(OR 0.53[95%CI 0.26-1.08;p=0.081])。
结论:总 SVD 评分与非叶性 ICH 部位相关。CAA 评分与叶性 ICH 之间无显著相关性,部分原因可能是叶性 ICH 的病因混杂,以及 CAA 评分中包含了脑白质高信号,这是 SVD 类型的非特异性标志物。