Subarachnoid extension of intracerebral hemorrhage and 90-day outcomes in INTERACT2

Stroke. 2014 Jan;45(1):258-60. doi: 10.1161/STROKEAHA.113.003524. Epub 2013 Oct 22.


Background and purpose: The prognostic significance of subarachnoid extension of intracerebral hemorrhage was determined in the INTEnsive blood pressure Reduction in Acute Cerebral hemorrhage Trial (INTERACT2) study.

Methods: INTERACT2 was an open randomized controlled trial of early intensive compared with guideline-recommended blood pressure lowering in patients with elevated systolic blood pressure within 6 hours of intracerebral hemorrhage. Independent predictors of death or major disability (scores 3-6 on the modified Rankin Scale) at 90 days were analyzed in logistic regression models.

Results: Of 2582 participants, 192 (7%) had subarachnoid extension, which was associated with larger hematoma volumes (P<0.0001) and higher National Institute of Health Stroke Scale score (P<0.0001). Subarachnoid extension predicted death or major disability at 90 days (71% versus 53%; unadjusted odds ratio, 2.25; 95% confidence interval, 1.63-3.10; P<0.0001). The association remained significant after adjusting for age, region, lipid-lowering therapy, systolic blood pressure, glucose, location of hematoma, intraventricular extension, and randomized treatment (odds ratio, 2.17; 95% confidence interval, 1.50-3.14; P<0.0001), but not after further adjustment for baseline hematoma volume (P=0.62).

Conclusions: Subarachnoid extension of intracerebral hemorrhage is associated with poor prognosis, which is determined by a larger volume of the underlying intraparenchymal hematoma.

Clinical trial registration: URL: Unique identifier: NCT00716079.

Keywords: assessment, outcomes; cerebral hemorrhage; clinical trial.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Blood Glucose / metabolism
  • Blood Pressure / physiology
  • Cerebral Hemorrhage / mortality
  • Cerebral Hemorrhage / pathology*
  • Cerebral Ventricles / pathology
  • Confidence Intervals
  • Disability Evaluation
  • Disease Progression
  • Guidelines as Topic
  • Humans
  • Hypolipidemic Agents / therapeutic use
  • Logistic Models
  • Odds Ratio
  • Predictive Value of Tests
  • Prognosis
  • Subarachnoid Hemorrhage / mortality
  • Subarachnoid Hemorrhage / pathology*
  • Treatment Outcome


  • Blood Glucose
  • Hypolipidemic Agents

Associated data