Asymptomatic Striatocapsular slit-like Hemorrhage as a Severity Marker in Patients with Hypertensive Angiopathy
Journal
Journal of Stroke and Cerebrovascular Diseases
Journal Volume
29
Journal Volume
29
Journal Issue
10
Journal Issue
10
Pages
105153
Start Page
105153
ISSN
1052-3057
Date Issued
2020-10
Author(s)
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.
SDGs
Other Subjects
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
Type
journal article