Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Rd, Chongqing, 400016, China.
Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China.
Neurocrit Care. 2024 Apr;40(2):743-749. doi: 10.1007/s12028-023-01831-0. Epub 2023 Sep 11.
The objective of this study was to investigate the clinical, imaging, and outcome characteristics of intracerebral hemorrhage (ICH) caused by structural vascular lesions.
We retrospectively analyzed data from a prospective observational cohort study of patients with spontaneous ICH admitted to the First Affiliated Hospital of Chongqing Medical University between May 2016 and April 2021. Good outcome was defined as modified Rankin Scale score of 0-3 at 3 months. The clinical and imaging characteristics were compared between primary ICH and ICH caused by structural vascular lesions. Multivariable logistic regression analysis was performed to test the associations of etiology with clinical outcome.
All patients enrolled in this study were Asian. Compared with patients with primary ICH, those with structural vascular lesions were younger (48 vs. 62 years, P < 0.001), had a lower incidence of hypertension (26.4% vs. 81.7%, P < 0.001) and diabetes (7.4% vs. 16.2%, P = 0.003), and had mostly lobar hemorrhages (49.1% vs. 22.8%). ICH from structural vascular lesions had smaller baseline hematoma volume (8.4 ml vs. 13.8 ml, P = 0.010), had lower mortality rate at 30 days and 3 months (5.8% vs. 12.0%, P = 0.020; 6.7% vs. 14.8%, P = 0.007), and are associated with better functional outcome at 3 months (88% vs.70.3%, P < 0.001).
Compared with primary ICH, ICH due to vascular lesions has smaller hematoma volume and less severe neurological deficit at presentation and better functional outcomes.
本研究旨在探讨由结构性血管病变引起的脑出血（ICH）的临床、影像学和预后特点。
我们回顾性分析了 2016 年 5 月至 2021 年 4 月期间重庆医科大学第一附属医院收治的自发性 ICH 患者的前瞻性观察队列研究数据。良好结局定义为 3 个月时改良 Rankin 量表评分为 0-3。比较原发性 ICH 和结构性血管病变引起的 ICH 的临床和影像学特征。采用多变量逻辑回归分析检验病因与临床结局的关系。
本研究所有纳入患者均为亚洲人。与原发性 ICH 患者相比，结构性血管病变患者年龄更小（48 岁 vs. 62 岁，P<0.001），高血压（26.4% vs. 81.7%，P<0.001）和糖尿病（7.4% vs. 16.2%，P=0.003）发生率较低，且多为脑叶出血（49.1% vs. 22.8%）。结构性血管病变引起的 ICH 基线血肿体积较小（8.4ml vs. 13.8ml，P=0.010），30 天和 3 个月的死亡率较低（5.8% vs. 12.0%，P=0.020；6.7% vs. 14.8%，P=0.007），3 个月时的功能结局更好（88% vs.70.3%，P<0.001）。
与原发性 ICH 相比，由血管病变引起的 ICH 发病时血肿体积较小，神经功能缺损较轻，功能结局较好。
