Document Detail


Acute brain infarcts after spontaneous intracerebral hemorrhage: a diffusion-weighted imaging study.
MedLine Citation:
PMID:  19892994     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: We aimed to determine the prevalence of acute brain infarcts using diffusion-weighted imaging (DWI) in patients with spontaneous intracerebral hemorrhage (ICH). METHODS: We collected data on consecutive patients with spontaneous ICH admitted to our institution between August 1, 2006 and December 31, 2008 and in whom DWI was performed within 28 days of admission. Patients with hemorrhage attributable to trauma, tumor, aneurysm, vascular malformation, and hemorrhagic conversion of arterial or venous infarction were excluded. Restricted diffusion within, contiguous with, or immediately neighboring the hematoma or chronic infarcts was not considered abnormal. Using multivariable logistic regression, we evaluated potential predictors of DWI abnormality including clinical and radiographic characteristics and treatments. A probability value <0.05 was considered significant in the final model. RESULTS: Among 118 spontaneous ICH patients (mean 59.6 years, 47.5% male, and 31.4% white) who also underwent MRI, DWI abnormality was observed in 22.9%. The majority of infarcts were small (median volume 0.25 mL), subcortical (70.4%), and subclinical (88.9%). Factors independently associated with DWI abnormality were prior ischemic stroke (P=0.002), MAP lowering by > or =40% (P=0.004), and craniotomy for ICH evacuation (P=0.001). CONCLUSIONS: We found that acute brain infarction is relatively common after acute spontaneous ICH. Several factors, including aggressive blood pressure lowering, may be associated with acute ischemic infarcts after ICH. These preliminary findings require further prospective study.
Authors:
Shyam Prabhakaran; Rajesh Gupta; Bichun Ouyang; Sayona John; Richard E Temes; Yousef Mohammad; Vivien H Lee; Thomas P Bleck
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-11-05
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  41     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2009-12-29     Completed Date:  2010-01-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  89-94     Citation Subset:  IM    
Affiliation:
Department of Neurological Sciences, Rush University Medical Center, 1725 W Harrison St Suite 1121, Chicago, IL 60612, USA. shyam_prabhakaran@rush.edu
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MeSH Terms
Descriptor/Qualifier:
African Continental Ancestry Group
Aged
Brain Infarction / diagnosis*,  etiology*
Cerebral Hemorrhage / complications*,  diagnosis*
Diffusion Magnetic Resonance Imaging*
European Continental Ancestry Group
Female
Humans
Male
Middle Aged
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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