Small subcortical infarcts and primary subcortical haemorrhages may have different risk factors.

Primary subcortical haemorrhages (SCH) and small subcortical infarcts (SSI) arise from changes in penetrating perforating arteries. The aim of this study was to compare cerebrovascular risk factors between patients with SCH and patients with SSI. Of 396 patients with a first-ever stroke (226 males; 170 females; median-age: 63), 108 had SSI, and 64 SCH, with or without subcortical infarcts co-existing. Patients with SCH were less likely to have current atrial fibrillation or associated non-lacunar infarcts, but they were more likely to have arterial hypertension (except after exclusion of patients with co-existence of SSI and SCH) and alcoholism, and they were significantly younger and had lower leukoaraiosis scores. The independent factors for SCH were alcoholism, arterial hypertension and lack of significant internal carotid artery stenosis. The only independent factor for SSI was leukoaraiosis score. Hypertension was the most important risk factor in both groups, but its prevalence was higher in the SCH group. Whether patients will develop SSI or SCH probably depends on associated risk factors such as alcohol consumption. Further studies should also take into account the characteristics of arterial hypertension.