|Title:||Asymptomatic Striatocapsular slit-like Hemorrhage as a Severity Marker in Patients with Hypertensive Angiopathy||Authors:||Tsai H.-H.
|Issue Date:||2020||Journal Volume:||29||Journal Issue:||10||Start page/Pages:||105153||Source:||Journal of Stroke and Cerebrovascular Diseases||Abstract:||
Background: Concomitant asymptomatic striatocapsular slit-like hemorrhage (SSH) is occasionally found in patients of spontaneous intracerebral hemorrhage (ICH), but was seldomly described in the literature. In this study, we described the clinico-radiological features of asymptomatic SSH in ICH patients with hypertensive microangiopathy. Methods and Results: 246 patients with strictly deep or mixed deep and lobar ICH/microbleeds were included. SSH was defined as hypointense lesions involving the lateral aspect of lentiform nucleus or external capsule in slit shape (>1.5 cm) on susceptibility-weighted imaging without history of associated symptoms. Demographics and neuroimaging markers were compared between patients with SSH and those without. Patients with SSH (n=24, 10%) and without SSH had comparable age (62.0 ± 12.6 vs. 62.3 ± 13.5, p = 0.912) and vascular risk factor profiles including the diagnosis of chronic hypertension, diabetes, and dyslipidemia (all p>0.05). SSH was associated with more common lobar microbleeds (79.2% vs 48.2%, p = 0.005), lacunes (75% vs. 41.4%, p = 0.002) and higher white matter hyperintensity (WMH) volumes (24.1 [10.4–46.3] vs. 13.9 [7.0–24.8] mL, p = 0.012) on MRI, as well as more frequent left ventricular hypertrophy (LVH) (50.0% vs. 20.5%, p = 0.004) and albuminuria (41.7% vs. 19.4%, p = 0.018). In multivariable analyses, SSH remains independently associated with LVH (p = 0.017) and albuminuria (p = 0.032) after adjustment for age, sex, microbleed, lacune and WMH volume. Conclusions: Asymptomatic SSH is associated with more severe cerebral small vessel disease-related change on brain MRI, and hypertensive cardiac and renal injury, suggesting a more advanced stage of chronic hypertension. ? 2020 Elsevier Inc.
|URI:||https://scholars.lib.ntu.edu.tw/handle/123456789/514635||ISSN:||1052-3057||DOI:||10.1016/j.jstrokecerebrovasdis.2020.105153||SDG/Keyword:||adult; albuminuria; Article; asymptomatic disease; brain hemorrhage; brain size; chronic disease; controlled study; cross-sectional study; disease severity; dyslipidemia; external capsule; female; heart left ventricle hypertrophy; human; hypertension; major clinical study; male; middle aged; neuroimaging; priority journal; striatocapsular slit like hemorrhage; susceptibility weighted imaging; aged; asymptomatic disease; brain hemorrhage; cerebrovascular disease; complication; corpus striatum; diagnostic imaging; diffusion weighted imaging; hypertension; predictive value; prognosis; register; risk factor; severity of illness index; Aged; Asymptomatic Diseases; Cerebral Small Vessel Diseases; Corpus Striatum; Cross-Sectional Studies; Diffusion Magnetic Resonance Imaging; External Capsule; Female; Humans; Hypertension; Intracranial Hemorrhage, Hypertensive; Male; Middle Aged; Predictive Value of Tests; Prognosis; Registries; Risk Factors; Severity of Illness Index
|Appears in Collections:||醫學院附設醫院 (臺大醫院)|
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