Okumura Motohiro, Sato Takeo, Maku Takahiro, Kitagawa Tomomichi, Takatsu Hiroki, Komatsu Teppei, Sakuta Kenichi, Sakai Kenichiro, Umehara Tadashi, Mitsumura Hidetaka, Murakami Hidetomo, Iguchi Yasuyuki
Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
Department of Neurology, The Jikei University School of Medicine, Tokyo, Japan.
J Neurol Sci. 2023 Jan 15;444:120523. doi: 10.1016/j.jns.2022.120523. Epub 2022 Dec 12.
To determine the impact of old lacunes and their sites on the prognosis of one-sided supratentorial intracerebral hemorrhage (ICH) by classifying lacunes sites in relation to anatomical structures using MRI.
Consecutive patients with one-sided supratentorial ICH ≤72 h from onset to door who underwent MRI were retrospectively included. The sites of old lacunes were categorized as follows: deep subcortical white matter, caudate head, lentiform, posterior limb and genu of the internal capsule, thalamus, and brainstem. We also evaluated all other cerebral small vessel disease markers. An unfavorable outcome was defined as a modified Rankin Scale score of 3 to 6 at 3 months after onset. We investigated whether old lacunes in particular locations were related to unfavorable outcomes.
We included 186 patients with one-sided supratentorial ICH (126 [68%] males, median age 62 years). Of 186 patients, 65 (35%) patients had unfavorable outcomes. Factors associated with unfavorable outcomes were age (OR 2.261, 95% CI 1.332-3.839, p = 0.003), National Institutes of Health Stroke Scale [NIHSS] score at admission (OR 1.175, 95% CI 1.090-1.267, p < 0.001), and old thalamic lacunes contralateral to the hematoma (OR 3.805, 95% CI 1.009-14.340, p = 0.048). Patients with old thalamic lacunes contralateral to the hematoma tended to have arm (p = 0.006) and leg (p = 0.011) motor impairment on the paralyzed side at discharge as estimated by the NIHSS score.
Old thalamic lacunes contralateral to the hematoma may be related to unfavorable outcomes in ICH.
