Document Detail


MRI markers of small vessel disease in lobar and deep hemispheric intracerebral hemorrhage.
MedLine Citation:
PMID:  20689084     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: MRI evidence of small vessel disease is common in intracerebral hemorrhage (ICH). We hypothesized that ICH caused by cerebral amyloid angiopathy (CAA) or hypertensive vasculopathy would have different distributions of MRI T2 white matter hyperintensity (WMH) and microbleeds.
METHODS: Data were analyzed from 133 consecutive patients with primary supratentorial ICH and adequate MRI sequences. CAA was diagnosed using the Boston criteria. WMH segmentation was performed using a validated semiautomated method. WMH and microbleeds were compared according to site of symptomatic hematoma origin (lobar versus deep) or by pattern of hemorrhages, including both hematomas and microbleeds, on MRI gradient recalled echo sequence (grouped as lobar only-probable CAA, lobar only-possible CAA, deep hemispheric only, or mixed lobar and deep hemorrhages).
RESULTS: Patients with lobar and deep hemispheric hematoma had similar median normalized WMH volumes (19.5 cm versus 19.9 cm(3), P=0.74) and prevalence of >or=1 microbleed (54% versus 52%, P=0.99). The supratentorial WMH distribution was similar according to hemorrhage location category; however, the prevalence of brain stem T2 hyperintensity was lower in lobar hematoma versus deep hematoma (54% versus 70%, P=0.004). Mixed ICH was common (23%). Patients with mixed ICH had large normalized WMH volumes and a posterior distribution of cortical hemorrhages similar to that seen in CAA.
CONCLUSIONS: WMH distribution is largely similar between CAA-related and non-CAA-related ICH. Mixed lobar and deep hemorrhages are seen on MRI gradient recalled echo sequence in up to one fourth of patients; in these patients, both hypertension and CAA may be contributing to the burden of WMH.
Authors:
Eric E Smith; Kaveer R N Nandigam; Yu-Wei Chen; Jed Jeng; David Salat; Amy Halpin; Matthew Frosch; Lauren Wendell; Louis Fazen; Jonathan Rosand; Anand Viswanathan; Steven M Greenberg
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2010-08-05
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  41     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2010-09-22     Revised Date:  2014-04-07    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1933-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Brain / pathology*,  physiopathology
Brain Mapping
Cerebral Amyloid Angiopathy / pathology*,  physiopathology
Cerebrovascular Disorders / etiology,  pathology*,  physiopathology
Diagnosis, Differential
Female
Humans
Hypertension / complications,  pathology,  physiopathology
Image Processing, Computer-Assisted
Magnetic Resonance Imaging*
Male
Middle Aged
Grant Support
ID/Acronym/Agency:
K23NS046327/NS/NINDS NIH HHS; K24NS056207/NS/NINDS NIH HHS; R01 AG026484/AG/NIA NIH HHS; R01AG026484/AG/NIA NIH HHS

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