Journal of Diagnostics Concepts & Practice >
Analysis of risk factors and prognosis of cerebral hemorrhage patients accompanied by cortical superficial siderosis
Received date: 2019-02-20
Online published: 2019-04-25
Objective: To investigate the related factors of cortical superficial siderosis (cSS) in cerebral hemorrhage patients associated with cerebral amylodid angiopathy (CAA) and its prognosis. Methods: A prospective study was performed on patients diagnosed as cerebral hemorrhage by CT within 3 days after onset and MRI was performed within 5 days for detecting cortical superficial siderosis (cSS ), cerebral microbleeds (CMBs) and leukoaraiosis (LA). Patients were followed up 1 year for observation of subsequent clinical cerebrovascular events. Result: Altogether 241 patients with cerebral hemorrhage were enrolled, including 185 cases of deep hemorrhage and 56 cases of lobar hemorrhage. The occurrence of cSS in lobar hemorrhage was more than that in deep hemorrhage (13/56, 23.2% vs 12/185, 6.5%, P<0.001). According to the modified Boston criteria, 42 patients (17.4%) were possible CAA. During the 1-year follow-up, 35 (14.5%) patients had clinical cerebrovascular events or death, and 13(31.0%) possible CAA patients had recurrent cerebral hemorrhage. Kaplan-Meier showed a higher risk of recurrent cerebral hemorrhage in possible CAA accompanied by cSS ( χ2=7.466, P=0.006). The multivariate COX regression model found that cSS was an independent predictor of recurrent cerebral hemorrhage in patients with possible CAA (HR 4.45; 95% CI 1.3714.48, P=0.013). Conclusions: The prevalence of cSS in patients with lobar hemorrhage was higher than that in deep bleeding. Possible CAA accompanied by cSS had an increased risk of recurrent cerebral hemorrhage within one year.
CHEN Jie, HU Jin, YANG Kang, FU Yi . Analysis of risk factors and prognosis of cerebral hemorrhage patients accompanied by cortical superficial siderosis[J]. Journal of Diagnostics Concepts & Practice, 2019 , 18(2) : 133 -138 . DOI: 10.16150/j.1671-2870.2019.02.003
[1] | 中华医学会神经病学分会, 中华医学会神经病学分会脑血管病学组. 中国脑出血诊治指南(2014)[J]. 中华神经科杂志, 2015, 48(6):435-444. |
[2] | 中华医学会神经外科学分会, 中国医师协会急诊医师分会, 国家卫生和计划生育委员会脑卒中筛查与防治工程委员会. 自发性脑出血诊断治疗中国多学科专家共识[J]. 中华神经外科杂志, 2015, 31(12): 1189-1194. |
[3] | Caetano A, Ladeira F, Barbosa R, et al. Cerebral amyloid angiopathy - The modified Boston criteria in clinical practice[J]. J Neurol Sci, 2018, 384:55-57. |
[4] | DeSimone CV, Graff-Radford J, El-Harasis MA, et al. Cerebral Amyloid Angiopathy: Diagnosis, Clinical Implications, and Management Strategies in Atrial Fibrillation[J]. J Am Coll Cardiol, 2017, 70(9):1173-1182. |
[5] | Charidimou A, Gang Q, Werring DJ. Sporadic cerebral amyloid angiopathy revisited: recent insights into pathophysiology and clinical spectrum[J]. J Neurol Neurosurg Psychiatry, 2012, 83(2):124-137. |
[6] | 冯玉兰, 蒋爱华, 颜静, 等. 脑血肿体积评估3种方法的比较研究[J]. 实用临床医药杂志, 2014, 18(11):26-30,36. |
[7] | Greenberg SM, Vernooij MW, Cordonnier C, et al. Cerebral microbleeds: a guide to detection and interpretation[J]. Lancet Neurol, 2009, 8(2):165-174. |
[8] | Cheng CY, Cheng HM, Chen SP, et al. White matter hyperintensities in migraine: Clinical significance and central pulsatile hemodynamic correlates[J]. Cephalalgia, 2018, 38(7):1225-1236. |
[9] | Gupta A, Giambrone AE, Gialdini G, et al. Silent Brain Infarction and Risk of Future Stroke: A Systematic Review and Meta-Analysis[J]. Stroke, 2016, 47(3):719-725. |
[10] | Charidimou A, Linn J, Vernooij MW, et al. Cortical superficial siderosis: detection and clinical significance in cerebral amyloid angiopathy and related conditions[J]. Brain, 2015, 138(Pt 8):2126-2139. |
[11] | Broderick JP, Adeoye O, Elm J. Evolution of the Modified Rankin Scale and Its Use in Future Stroke Trials[J]. Stroke, 2017, 48(7):2007-2012. |
[12] | Yaghi S, Rostanski SK, Boehme AK, et al. Imaging Parameters and Recurrent Cerebrovascular Events in Patients With Minor Stroke or Transient Ischemic Attack[J]. JAMA Neurol, 2016, 73(5):572-578. |
[13] | 时景璞, 滕卫禹, 王海龙, 等. 高血压高发区人群脑卒中患病现状的流行病学调查[J]. 中国卫生统计, 2006, 23(1):47-49. |
[14] | Pantoni L. Cerebral small vessel disease: from pathoge-nesis and clinical characteristics to therapeutic challenges[J]. Lancet Neurol, 2010, 9(7):689-701. |
[15] | Cordonnier C, Al-Shahi Salman R, Wardlaw J. Spontaneous brain microbleeds: systematic review, subgroup analyses and standards for study design and reporting[J]. Brain, 2007, 130(Pt 8):1988-2003. |
[16] | Greenberg SM, Nandigam RN, Delgado P, et al. Microbleeds versus macrobleeds: evidence for distinct entities[J]. Stroke, 2009, 40(7):2382-2386. |
[17] | Linn J, Herms J, Dichgans M, et al. Subarachnoid hemosiderosis and superficial cortical hemosiderosis in cerebral amyloid angiopathy[J]. Am J Neuroradiol, 2008, 29(1):184-186. |
[18] | Linn J, Michl S, Katja B, et al. Cortical vein thrombosis: the diagnostic value of different imaging modalities[J]. Neuroradiology, 2010, 52(10):899-911. |
[19] | Kumar S, Goddeau RP, Jr, Selim MH, et al. Atraumatic convexal subarachnoid hemorrhage: clinical presentation, imaging patterns, and etiologies[J]. Neurology, 2010, 74(11):893-899. |
[20] | Na HK, Park JH, Kim JH, et al. Cortical superficial siderosis: a marker of vascular amyloid in patients with cognitive impairment[J]. Neurology, 2015, 84(8):849-855. |
[21] | Samarasekera N, Smith C, Al-Shahi Salman R. The association between cerebral amyloid angiopathy and intrace-rebral haemorrhage: systematic review and meta-analysis[J]. J Neurol Neurosurg Psychiatry, 2012, 83(3):275-281. |
[22] | Hemphill JC 3rd, Greenberg SM, Anderson CS, et al. Guidelines for the Management of Spontaneous Intrace-rebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association[J]. Stroke, 2015, 46(7):2032-2060. |
[23] | Wermer MJH, Greenberg SM. The growing clinical spectrum of cerebral amyloid angiopathy[J]. Curr Opin Neurol, 2018, 31(1):28-35. |
[24] | Wieberdink RG, Poels MM, Vernooij MW, et al. Serum lipid levels and the risk of intracerebral hemorrhage: the Rotterdam Study[J]. Arterioscler Thromb Vasc Biol, 2011, 31(12):2982-2989. |
[25] | Phuah CL, Raffeld MR, Ayres AM, et al. Subacute decline in serum lipids precedes the occurrence of primary intracerebral hemorrhage[J]. Neurology, 2016, 86(22):2034-2041. |
[26] | Shoamanesh A, Martinez-Ramirez S, Oliveira-Filho J, et al. Interrelationship of superficial siderosis and microbleeds in cerebral amyloid angiopathy[J]. Neurology, 2014, 83(20):1838-1843. |
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