医学
改良兰金量表
冲程(发动机)
脑出血
内科学
腔隙性中风
心脏病学
外科
放射科
格拉斯哥昏迷指数
缺血性中风
缺血
机械工程
工程类
作者
Martina Goeldlin,Jan Vynckier,Madlaine Müller,Boudewijn Drop,Basel Maamari,Noah Vonlanthen,Bernhard Siepen,Arsany Hakim,Johannes Kaesmacher,Christopher Marvin Jesse,Christoph Mueller,Thomas Meinel,Morin Beyeler,Leander Clénin,Jan Gralla,Werner J Z Graggen,David Bervini,Marcel Arnold,Urs Fischer,David Seiffge
标识
DOI:10.1177/23969873231193237
摘要
Introduction: Deep perforator arteriolopathy (DPA) causes intracerebral haemorrhage (ICH) and lacunar strokes (LS). We compare patient characteristics, MRI findings and clinical outcomes among patients with deep ICH and LS. Patients and methods: We included patients with MRI-confirmed LS or ICH in the basal ganglia, thalamus, internal capsule or brainstem from the Bernese Stroke Registry. We assessed MRI small vessel disease (SVD) markers, SVD burden score, modified Rankin Scale (mRS) and ischaemic stroke or ICH at 3 months. Results: We included 716 patients, 117 patients (16.3%) with deep ICH (mean age (SD) 65.1 (±15.2) years, 37.1% female) and 599 patients (83.7%) with LS (mean age (SD) 69.7 (±13.6) years, 39.9% female). Compared to LS, deep ICH was associated with a higher SVD burden score (median (IQR) 2 (1–2) vs 1 (0–2)), aOR shift 3.19, 95%CI 2.15–4.75). Deep ICH patients had more often cerebral microbleeds (deep ICH: 71.6% vs LS: 29.2%, p < 0.001, median count (IQR) 4(2–12) vs 2(1–6)) and a higher prevalence of lacunes (deep ICH: 60.5% vs LS: 27.4% p < 0.001). At 3 months, deep ICH was associated with higher mRS (aOR shift 2.16, 95%CI 1.21–3.87). Occurrence of ischaemic stroke was numerically but not significantly higher in deep ICH (4.3% vs 2.9%; p = 0.51). One patient (1.1%) with ICH but none with LS suffered ICH recurrence. Discussion/Conclusion: DPA manifesting as ICH is associated with more severe MRI SVD burden and worse outcome compared to LS. The short-term risks of subsequent ischaemic stroke and recurrent ICH are similar in ICH and LS patients. This implies potential consequences for future secondary prevention strategies.
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