Yang Qiong, Zeng Xiangzhu, Yu Zhou, Liu Xiaolu, Tang Lu, Zhang Gaoqi, Tian Danyang, Li Nan, Fan Dongsheng
Department of Neurology, Peking University Third Hospital, Beijing, China.
Department of Radiology, Peking University Third Hospital, Beijing, China.
Front Neurol. 2022 Mar 23;13:843851. doi: 10.3389/fneur.2022.843851. eCollection 2022.
Convexity subarachnoid hemorrhage (cSAH) may predict an increased recurrence risk in cerebral amyloid angiopathy (CAA)-related intracerebral hemorrhage (ICH) survivors. We aimed to investigate whether cSAH detected on CT was related to early recurrence in patients with ICH related to CAA.
We analyzed data from consecutive lobar ICH patients diagnosed as probable or possible CAA according to the Boston criteria using the method of cohort study. Demographic and clinical data, ICH recurrence at discharge and within 90 days were collected. The association between cSAH detected on CT and early recurrent ICH was analyzed using multivariable logistic regression.
A total of 197 cases (74 [66-80] years) were included. cSAH was observed on the baseline CT of 91 patients (46.2%). A total of 5.1% (10/197) and 9.5% (17/179) of patients experienced ICH recurrence within 2 weeks and 90 days, respectively. The presence of cSAH was related to recurrence within 2 weeks (OR = 5.705, 95%CI 1.070-30.412, = 0.041) after adjusting for hypertension, previous symptomatic ICH and anticoagulant use. The presence of cSAH was related to recurrence within 90 days (OR 5.473, 95%CI 1.425-21.028, = 0.013) after adjusting for hypertension, previous symptomatic ICH and intraventricular hemorrhage. The similar results were obtained in other models using different methods to select adjusting variables.
In patients with lobar ICH related to CAA, 5.1% and 9.5% of them experienced ICH recurrence within 2 weeks and 90 days, respectively. CT-visible cSAH was detected in 46.2% of patients and indicates an increased risk for early recurrent ICH.
凸面蛛网膜下腔出血（cSAH）可能预示着脑淀粉样血管病（CAA）相关脑出血（ICH）幸存者的复发风险增加。我们旨在研究CT上检测到的cSAH是否与CAA相关ICH患者的早期复发有关。
我们采用队列研究方法分析了根据波士顿标准诊断为可能或疑似CAA的连续性脑叶ICH患者的数据。收集了人口统计学和临床数据、出院时及90天内的ICH复发情况。采用多变量逻辑回归分析CT上检测到的cSAH与早期复发性ICH之间的关联。
共纳入197例患者（年龄74[66 - 80]岁）。91例患者（46.2%）的基线CT上观察到cSAH。分别有5.1%（10/197）和9.5%（17/179）的患者在2周内和90天内发生ICH复发。在调整高血压、既往有症状性ICH和抗凝药物使用后，cSAH的存在与2周内复发相关（OR = 5.705，95%CI 1.070 - 30.412，P = 0.041）。在调整高血压、既往有症状性ICH和脑室内出血后，cSAH的存在与90天内复发相关（OR 5.473，95%CI 1.425 - 21.028，P = 0.013）。使用不同方法选择调整变量的其他模型也得到了类似结果。
在CAA相关脑叶ICH患者中，分别有5.1%和9.5%的患者在2周内和90天内发生ICH复发。46.2%的患者检测到CT可见的cSAH，这表明早期复发性ICH的风险增加。
