Presenter of 1 Presentation
CT-VISIBLE CONVEXITY SUBARACHNOID HEMORRHAGE PREDICTS EARLY RECURRENCE OF LOBAR HEMORRHAGE
Abstract
Background and Aims
Cerebral amyloid angiopathy (CAA) is a major cause of intracerebral hemorrhage (ICH) in elderly, with high recurrent risk. Convexity subarachnoid hemorrhage (cSAH) on MRI may predict ICH recurrence, and CT-visible cSAH may indicate increased recurrence risk in CAA-related ICH survivors after discharge. We aimed to investigate the association of CT-visible cSAH and early recurrence in patients with CAA-related ICH.
Methods
Patients diagnosed as possible or probable CAA according to Boston criteria from 2 prospective cohorts from 21 hospitals in China during Jan. 2015 to Feb. 2020 were included. The demographic, clinical and imaging data, ICH recurrence at discharge and 90-day follow-up were collected. Presence of cSAH was assessed on CT. The association of cSAH and early recurrence was explored using multivariable analysis.
Results
A total 197 cases (73.3±8.9 years) were included. cSAH was observed on CT in 91 patients (46.2%). 5.1% (10/197) and 9.5% (17/179) patients had ICH recurrence within 2 weeks and 90 days respectively. The presence of cSAH was related to 2-week recurrence (p= 0.041), after adjusted for hypertension, anticoagulant use and history of previous ICH. The presence of cSAH was related to 90-day recurrence (P= 0.013), after adjusted for hypertension, history of previous ICH and intraventricular hemorrhage. Prespecified multivariable analysis also showed cSAH was related to 2-week recurrence (p= 0.029) and 90-day recurrence (p=0.007), after adjusted for age, antiplatelet use, warfarin use and history of previous ICH.
Conclusions
CT-visible cSAH was detected in 46.3% of patients with CAA related ICH and indicates an increased risk of recurrent ICH.