Differences Between Vascular Structural Abnormality and Hypertensive Intracerebral Hemorrhage

Chunyan Lei; Bo Wu; Ming Liu; Tian Cao; Qiuxiao Wang; Wei Dong

doi:10.1016/j.jstrokecerebrovasdis.2015.04.006

Differences Between Vascular Structural Abnormality and Hypertensive Intracerebral Hemorrhage

J Stroke Cerebrovasc Dis. 2015 Aug;24(8):1811-6. doi: 10.1016/j.jstrokecerebrovasdis.2015.04.006. Epub 2015 Jun 13.

Authors

Chunyan Lei¹, Bo Wu¹, Ming Liu², Tian Cao¹, Qiuxiao Wang¹, Wei Dong¹

Affiliations

¹ Department of Neurology, Stroke Clinical Research Unit, West China Hospital, Sichuan University, Chengdu, P. R. China.
² Department of Neurology, Stroke Clinical Research Unit, West China Hospital, Sichuan University, Chengdu, P. R. China. Electronic address: wyplmh@hotmail.com.

PMID: 26077131
DOI: 10.1016/j.jstrokecerebrovasdis.2015.04.006

Abstract

Background: How the clinical characteristics and prognosis of various types of vascular structural abnormality-related intracerebral hemorrhage (ICH) differ from those of hypertensive ICH is poorly understood. This lack of understanding poses a problem for differential diagnosis and prognosis.

Methods: Patients diagnosed with ICH between January 2012 and February 2014 at 50 tertiary and secondary hospitals in China were enrolled into this prospective cohort study. Patients were classified as having vascular structural abnormality-related ICH or hypertensive ICH, and data on the demographics and clinical characteristics of each group were compared. Multivariate logistic regression was used to explore associations while controlling for other risk factors for good outcome and mortality.

Results: Data for 281 patients showed that vascular structural abnormality-related ICH usually occurred in lobar areas and affected patients who were younger and had higher Glasgow Coma Scale (GCS) scores than those with hypertensive ICH. Mortality and good outcome at 3 months after ICH were significantly better among patients with vascular structural abnormality-related ICH (3.4% and 77.2%) than among patients with hypertensive ICH (15.2% and 49.9%, both P < .001). Multivariate logistic regression identified the following independent predictors of mortality: lower GCS score, old age, presence of intraventricular hemorrhage, larger hematoma volume, and surgery treatment. The regression also identified several independent predictors of good outcome at 3 months: ICH etiology due to vascular structural abnormality, higher GCS score, younger age, and smaller hematoma volume.

Conclusions: Patients with vascular structural abnormality-related ICH are more likely to experience better clinical outcomes than those with hypertensive ICH. GCS score, age, hematoma volume, and ICH etiology are independent predictors of ICH outcome.

Keywords: Vascular structural abnormality; functional outcome; hypertension; intracerebral hemorrhage; mortality.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
China / epidemiology
Cohort Studies
Female
Glasgow Coma Scale
Humans
Intracranial Hemorrhage, Hypertensive / diagnosis*
Logistic Models
Magnetic Resonance Imaging
Male
Middle Aged
Tomography, X-Ray Computed
Vascular System Injuries / diagnosis*
Young Adult