Higher Cerebral Small Vessel Disease Burden in Patients With Small Intracerebral Hemorrhage

Zi-Jie Wang; Rui Zhao; Xiao Hu; Wen-Song Yang; Lan Deng; Xin-Ni Lv; Zuo-Qiao Li; Jing Cheng; Ming-Jun Pu; Zhou-Ping Tang; Guo-Feng Wu; Li-Bo Zhao; Peng Xie; Qi Li

doi:10.3389/fnins.2022.888198

Higher Cerebral Small Vessel Disease Burden in Patients With Small Intracerebral Hemorrhage

Front Neurosci. 2022 May 12:16:888198. doi: 10.3389/fnins.2022.888198. eCollection 2022.

Authors

Zi-Jie Wang¹, Rui Zhao², Xiao Hu¹, Wen-Song Yang^{1

3}, Lan Deng¹, Xin-Ni Lv¹, Zuo-Qiao Li¹, Jing Cheng¹, Ming-Jun Pu¹, Zhou-Ping Tang⁴, Guo-Feng Wu⁵, Li-Bo Zhao², Peng Xie^{1

3}, Qi Li^{1

3

6}

Affiliations

¹ Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
² Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China.
³ National Health Commission (NHC) Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
⁴ Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁵ Emergency Department, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.
⁶ Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States.

Abstract

Objective: To investigate the association between cerebral small vessel disease (SVD) and hematoma volume in primary intracerebral hemorrhage (ICH).

Methods: Patients from a prospective ICH cohort were enrolled. Admission and follow-up CT scan within 72 h after onset were reviewed to calculate the final hematoma volume. We evaluated cortical superficial siderosis and the global SVD score, including white matter hyperintensities, lacunes, enlarged perivascular space, and cerebral microbleeds on MRI. We conducted the multivariate logistic regression analyses to explore the association between SVD markers and small ICH, as well as hematoma volume. Hematoma location was stratified into lobar and non-lobar for subgroup analysis.

Results: A total of 187 patients with primary ICH (mean age 62.4 ± 13.4 years, 67.9% male) were enrolled. 94 (50.2%) patients had small ICH. The multivariate logistic regression analysis showed an association between global SVD score and small ICH [adjusted odds ratio (aOR) 1.27, 95% CI 1.03-1.57, p = 0.027] and a trend of higher global SVD score towards non-lobar small ICH (aOR 1.23, 95% CI 0.95-1.58, p = 0.122). In the multivariate linear regression analysis, global SVD score was inversely related to hematoma volume of all ICH (β = -0.084, 95% CI -0.142 to -0.025, p = 0.005) and non-lobar ICH (β = -0.112, 95% CI -0.186 to -0.037, p = 0.004). Lacune (β = -0.245, 95% CI -0.487 to -0.004, p = 0.046) was associated with lower non-lobar ICH volume.

Conclusion: Global SVD score is associated with small ICH and inversely correlated with hematoma volume. This finding predominantly exists in non-lobar ICH.

Keywords: cerebral small vessel disease; computed tomography; intracerebral hemorrhage; magnetic resonance imaging; neuroimaging; stroke.