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  • 1
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    Correlation of Cerebral Microbleed Distribution to Amyloid Burden in Patients with Primary Intracerebral Hemorrhage
    Springer Science and Business Media LLC ; 2017
    In:  Scientific Reports Vol. 7, No. 1 ( 2017-03-17)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 7, No. 1 ( 2017-03-17)
    Abstract: The underlying pathology of cerebral microbleeds (CMBs) with mixed lobar and deep distribution remains contentious. The aim of this study was to correlate CMBs distribution to β-amyloid burden in patients with primary intracerebral hemorrhage (ICH). Fourty-seven ICH patients underwent magnetic resonance susceptibility-weighted imaging and 11 C-Pittsburgh Compound B positron emission tomography. The amyloid burden was expressed as standardized uptake value ratio with reference to cerebellum, and presented as median (interquartile range). Patients were categorized into the lobar, mixed (both lobar and deep regions), and deep types of CMB. Comparing the lobar (17%), mixed (59.6%) and deep (23.4%) CMB types, the global amyloid burden was significantly higher in the mixed type than the deep type (1.10 [1.03–1.25] vs 1.00 [0.97–1.09], p  = 0.011), but lower than in the lobar type (1.48 [1.18–1.50], p  = 0.048). On multivariable analysis, the ratio of lobar to deep CMB number was positively correlated with global ( p  = 0.028) and occipital ( p  = 0.031) amyloid burden. In primary ICH, patients with lobar and mixed CMB types are associated with increased amyloid burden than patients with deep type. The ratio of lobar to deep CMB number is an independent indicator of cerebral β-amyloid deposition.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/srep44715
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2017
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  • 2
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    Abstract TP342: Asymptomatic Striatocapsular Slit-Like Hemorrhage as a Severity Marker in Patients With Hypertensive Intracerebral Hemorrhage/Microbleeds
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Stroke Vol. 51, No. Suppl_1 ( 2020-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. Suppl_1 ( 2020-02)
    Abstract: Background: Concomitant asymptomatic striatocapsular slit-like hemorrhage (SSH) is occasionally found in patients of hypertensive intracerebral hemorrhage (ICH), but was seldom reported. The correlation between hypertension severity and cerebral hemorrhagic pattern has not been well investigated, either. In this study, we described the clinico-radiological features of previous asymptomatic SSH in ICH patients with hypertensive angiopathy. Methods: 246 patients with strictly deep or mixed deep and lobar ICH/CMBs were included. SSH was defined as hypointense lesions involving the lateral aspect of lentiform nucleus or external capsule in slit shape ( 〉 1.5cm) on susceptibility-weighted imaging without history of associated symptoms (Figure 1). Demographics and neuroimaging markers were compared between patients with SSH and those without. The association between SSH and left ventricular hypertrophy (LVH) or proteinuria was investigated in univariable and multivariable logistic regression models. Results: Patients with SSH (n=24, 10%) and without SSH (n=222, 90%) had comparable age (62.0 ± 12.6 vs. 62.3 ± 13.5, p=0.912) and vascular risk factor profiles (all p 〉 0.05). SSH was associated with more common lobar CMBs (79.2% vs 48.2%, p=0.005), lacunes (75% vs. 41.4%, p=0.002) and higher white matter hyperintensity (WMH) volumes (12.0 [7.7-26.8] vs. 8.7 [4.3-16.1] mL, p=0.016) on MRI, as well as more frequent LVH (50.0% vs. 20.3%, p=0.004) and proteinuria (41.7% vs. 19.4%, p=0.018). In multivariable analyses, SSH remains independently associated with LVH (Odds ratio 2.8 [1.1-7.3], p=0.033) and proteinuria (Odds ratio 2.6 [1.0-6.6] , p=0.041) after adjustment for age, sex, CMBs, 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.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.51.suppl_1.TP342
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 3
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    Abstract WMP107: Outcomes in Mixed Location Intracerebral Hemorrhage and Microbleeds
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Stroke Vol. 51, No. Suppl_1 ( 2020-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. Suppl_1 ( 2020-02)
    Abstract: Objective: Patients with mixed location intracerebral hemorrhages/microbleeds (Mixed-ICH) have predominantly hypertensive vasculopathy rather than cerebral amyloid angiopathy (CAA), but the long-term outcomes in Mixed-ICH is unknown. In this study, we aimed to determine whether Mixed-ICH is a risk factor for vascular unfavorable outcome compared to CAA-ICH or strictly deep hypertensive intracerebral hemorrhage/microbleeds (HTN-ICH). Methods: 305 consecutive ICH patients were included. Clinical data, neuroimaging markers and follow-up outcomes (recurrent ICH, ischemic stroke and vascular death) were compared between Mixed-ICH (n=151), CAA-ICH (n=33) and HTN-ICH (n=121). The association between follow-up events and neuroimaging markers were explored using multivariable Cox regression models. Results: Mixed-ICH patients were older (65.9±12.4 vs 58.1±13.2, p 〈 0.001) than HTN-ICH, but younger than CAA-ICH patients (73.8 ± 13.9, p=0.001). The survival curves of follow-up outcomes were shown in the Figure. Compared to CAA-ICH, Mixed-ICH has similar incidence of vascular event (all P 〉 0.05). Compared to HTN-ICH, Mixed-ICH is associated with higher ICH recurrence (hazard ratio [HR]=3.0 [1.2-7.7] , p=0.021), more ischemic stroke (HR=8.2 [1.0-65.8], p=0.048), and vascular composite outcome (HR=3.5 [1.5-8.2] , p=0.003) after adjustment for age and sex. In patients of Mixed-ICH, the presence of cortical superficial siderosis (cSS) is associated the development of ICH recurrence (p=0.048), ischemic stroke (p=0.009), and vascular composite outcome (p=0.008). The association between cSS and vascular composite outcome remains significant after further adjustment for microbleed number, lacune and WMH volume (p=0.019). Conclusions: Mixed-ICH harbors higher risk of unfavorable vascular outcome than HTN-ICH. Presence of cSS in Mixed-ICH independently predicts vascular event, suggesting the contribution of detrimental effect due to coexisting CAA.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.51.suppl_1.WMP107
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 4
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    Abstract TP330: Lacune Distribution in Asians With Primary Intracerebral Hemorrhage: An MRI and Amyloid PET Study
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Stroke Vol. 49, No. Suppl_1 ( 2018-01-22)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 49, No. Suppl_1 ( 2018-01-22)
    Abstract: Background: Lacunar infarcts located in centrum-semiovale and lobar regions were more frequent in Caucasians with intracerebral hemorrhage related to cerebral amyloid angiopathy (CAA-ICH) while deep-seated lacunes in ICH related to hypertension (HTN-ICH), but these associations have never been validated in Asian patients. In the present study, we evaluated whether lobar lacunes were associated with core CAA markers such as lobar microbleeds (CMB) and higher amyloid load on 11 C-Pittsburgh Compund B (PiB) PET in an Asian ICH population. Methods: One hundred and ten patients of primary ICH who received MRI scans were classified as CAA-ICH or HTN-ICH according with the presence of strictly lobar or strictly deep bleeds (both ICH and CMBs), respectively. Lacunes were evaluated in the supratentorial area and classified as lobar (when located in CSO, frontal, parietal, insular/subinsular, temporal, and occipital lobes) or deep (when located in thalamus, basal ganglion, internal and external capsule) based on the location. A subgroup of 36 patients also underwent PiB-PET and global standardized uptake value ratio (SUVR) were calculated. Results: There were 24 CAA-ICH (mean age 70.9 ± 13.9) and 86 HTN-ICH (mean age 59.3 ± 13.0). Lobar lacunes were more frequent in CAA-ICH than HTN-ICH (29.2 vs 11.6%, p=0.036). In univariate analysis, lobar lacunes were significantly related to lobar CMB (p 〈 0.001) and white matter hyperintensity (WMH) severity (p=0.001). In multivariable models, lobar lacunes were again associated with lobar CMB (Odds ratio 6.9, 95 % confidence interval 1.5-31.3, p=0.011) after adjustment for age, sex, hypertension and WMH. In 15 CAA-ICH and 21 HTN-ICH patients with PiB PET, correlation analyses between lobar lacune counts and global SUVR was high (r=0.40, p=0.02) and remained significant after adjustment for age ( r =0.34, p=0.04). Conclusion: Lobar lacunes were more frequent in Asian patients with CAA-related strictly lobar hemorrhages. Their independent association with lobar CMB and brain amyloid deposition suggests a strong relationship with CAA even in an Asian cohort with overall higher hypertensive load.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.49.suppl_1.TP330
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
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  • 5
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    Superficial Cerebellar Microbleeds and Cerebral Amyloid Angiopathy : A Magnetic Resonance Imaging/Positron Emission Tomography Study
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Stroke Vol. 51, No. 1 ( 2020-01), p. 202-208
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. 1 ( 2020-01), p. 202-208
    Abstract: The differentiation between cerebral amyloid angiopathy (CAA) and hypertensive small vessel disease in primary intracerebral hemorrhage is mainly based on hemorrhagic neuroimaging markers in the supratentorial regions, and the cause for cerebellar microbleeds remains unknown. Our aim was to investigate whether superficial cerebellar microbleeds are more likely to be related to CAA rather than hypertensive small vessel disease. Methods— Two hundred seventy-five consecutive patients with intracerebral hemorrhage were retrospectively reviewed from a prospectively maintained hospital-based stroke registry. Eighty-five (33.1%) patients had cerebellar microbleeds and were categorized into superficial (gray matter, vermis), deep (white matter, deep nucleus, cerebellar peduncle), or mixed type based on the location of cerebellar hemorrhagic lesions. Amyloid imaging was obtained using 11C-Pittsburgh Compound B–positron emission tomography in a subgroup of patients. The associations between cerebellar microbleed locations and the type of small vessel disease (CAA versus hypertensive small vessel disease) based on distribution of supratentorial hemorrhagic lesions as well as other magnetic resonance imaging and positron emission tomography markers were analyzed. Results— The presence of cerebellar microbleed was independently associated with supratentorial microbleed and lacunar infarcts (both P 〈 0.01). Strictly superficial cerebellar microbleeds were significantly related to CAA–intracerebral hemorrhage, cortical superficial siderosis and high-grade enlarged perivascular space in centrum semiovale (all P 〈 0.05); deep or mixed cerebellar microbleeds were related to hypertension and deep microbleed (all P 〈 0.05). In multivariable models, superficial cerebellar microbleeds were independently associated with CAA–intracerebral hemorrhage ( P =0.03). Of 33 patients assessed by amyloid positron emission tomography, cerebral and cerebellar amyloid load (standardized uptake value ratio) was higher in patients with superficial cerebellar microbleeds compared with deep/mixed cerebellar microbleeds (cerebrum standardized uptake value ratio [reference: cerebellum] 1.33±0.24 versus 1.05±0.09, P 〈 0.001; cerebellum standardized uptake value ratio [reference: pons] 0.58±0.08 versus 0.51±0.09, P =0.03). Conclusions— Patients with strictly superficial cerebellar microbleeds are associated with a clinicoradiological diagnosis of CAA as well as increased cerebral and cerebellar amyloid deposition on Pittsburgh Compound B–positron emission tomography, suggesting underlying CAA pathology.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.119.026235
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 6
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    Online Resource
    Microangiopathy underlying mixed-location intracerebral hemorrhages/microbleeds : A PiB-PET study
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Neurology Vol. 92, No. 8 ( 2019-02-19), p. e774-e781
    Details
    In: Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 92, No. 8 ( 2019-02-19), p. e774-e781
    Abstract: To test the hypothesis that patients with concomitant lobar and deep intracerebral hemorrhages/microbleeds (mixed ICH) have predominantly hypertensive small vessel disease (HTN-SVD) rather than cerebral amyloid angiopathy (CAA), using in vivo amyloid imaging. Methods Eighty Asian patients with primary ICH without dementia were included in this cross-sectional study. All patients underwent brain MRI and 11 C-Pittsburgh compound B (PiB)-PET imaging. The mean cortical standardized uptake value ratio (SUVR) was calculated using cerebellum as reference. Forty-six patients (57.5%) had mixed ICH. Their demographic and clinical profile as well as amyloid deposition patterns were compared to those of 13 patients with CAA-ICH and 21 patients with strictly deep microbleeds and ICH (HTN-ICH). Results Patients with mixed ICH were younger (62.8 ± 11.7 vs 73.3 ± 11.9 years in CAA, p = 0.006) and showed a higher rate of hypertension than patients with CAA-ICH ( p 〈 0.001). Patients with mixed ICH had lower PiB SUVR than patients with CAA (1.06 [1.01–1.13] vs 1.43 [1.06–1.58] , p = 0.003). In a multivariable logistic regression model, mixed ICH was associated with hypertension (odds ratio 8.9, 95% confidence interval 1.4–58.4, p = 0.02) and lower PiB SUVR (odds ratio 0.03, 95% confidence interval 0.001–0.87, p = 0.04) compared to CAA after adjustment for age. Compared to HTN-ICH, mixed ICH showed a similar mean age (62.8 ± 11.7 vs 60.1 ± 14.5 years in HTN-ICH) and risk factor profile (all p 〉 0.1). Furthermore, PiB SUVR did not differ between mixed ICH (values presented above) and HTN-ICH (1.10 [1.00–1.16], p = 0.45). Conclusions: Patients with mixed ICH have much lower amyloid load than patients with CAA-ICH, while being similar to HTN-ICH. Overall, mixed ICH is probably caused by HTN-SVD, an important finding with clinical relevance.
    Type of Medium: Online Resource
    ISSN: 0028-3878 , 1526-632X
    URL: Article
    DOI: 10.1212/WNL.0000000000006953
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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  • 7
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    Abstract WMP104: Associations Between Lobar Microbleed and PiB Negative Intracerebral Hemorrhage.
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Stroke Vol. 48, No. suppl_1 ( 2017-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 48, No. suppl_1 ( 2017-02)
    Abstract: Background and Purpose: Cerebral microbleed (CMB) in the lobar region is regarded as an image marker for cerebral amyloid angiopathy (CAA), but it is sometimes encountered in patients with intracerebral hemorrhage (ICH) owing to hypertension or other small vessel disease (SVD). Recently, enlarged perivascular space (EPVS) in white matter and deep region was suggested to be another potential marker for SVD. Knowledge of CMB location and EPVS in patients with ICH in relation to amyloid deposition might help us understand its heterogeneous pathophysiology. Methods: Fifty-seven primary, spontaneous ICH patients underwent magnetic resonance imaging (MRI) with susceptibility-weighted imaging (SWI) to analyze the CMB, the EPVS in basal ganglia (BG) and centrum semiovale (CSO), and the overall white matter hyperintensity (WMH). 11 C-Pittsburgh Compound B (PiB) positron emission tomography was also performed to measure the global amyloid deposition and was quantified as standardized uptake value ratio (SUVR) using cerebellum as the reference. Results: Twenty-six patients with lobar ICH and 31 patients with deep ICH were included. Positive PiB scan (SUVR 〉 1.13) was found in 37% of patients (11 lobar ICH, 10 deep ICH). Presence of lobar CMB was found in 65% of patients irrespective of PiB scan status (p=0.084), but PiB (+) had higher number of lobar CMB (14.6 ± 16.9 vs. 5.4± 10.1, p=0.014) compared with PiB (-) patients. In PiB (-) patients, the number of lobar CMB is positively correlated with the number of deep CMB (p 〈 0.001, r=0.773). The presence of lobar CMB in PiB (-) patients is also associated with severe EPVS in BG (70% vs. 31%, p=0.042), but not in CSO (p=0.073). Conclusions: Lobar CMB can be found in more than half of ICH patients irrespective of PiB scan status, but higher number of lobar CMB is seen in PiB (+) ICH patients. In PiB (-) patients, the presence of lobar CMB is associated with higher deep CMB number and EPVS in BG, suggesting the contribution of hypertensive angiopathy instead of amyloid angiopathy.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.48.suppl_1.wmp104
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
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  • 8
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    Abstract WMP100: Underlying Microangiopathy of Mixed Location Intracerebral Hemorrhage and Microbleeds: a PiB-PET Study
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Stroke Vol. 49, No. Suppl_1 ( 2018-01-22)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 49, No. Suppl_1 ( 2018-01-22)
    Abstract: Background: Recent MRI-based work suggested that the predominant type of cerebral small vessel disease (SVD) in patients with a combination of lobar and deep intracerebral hemorrhage (ICH)/microbleed (MB) locations (Mixed-ICH) was hypertensive (HTN) SVD. We sought to use in vivo amyloid imaging to test the hypothesis that mixed-ICH is related to HTN-SVD rather than cerebral amyloid angiopathy (CAA). Methods: Eighty Asian primary ICH patients without dementia were included in this study. All patients underwent brain MRI and 11 C-Pittsburgh Compound B (PiB) PET. The global, occipital and frontal standardized uptake value ratio (SUVR) were calculated using cerebellum as reference. Fourty-six (51%) patients had Mixed-ICH. Their demographic and clinical profile as well as amyloid deposition patterns were compared to 13 probable CAA (Boston criteria; CAA-ICH) and 21 strictly deep-MB and ICH (HTN-ICH) patients. Results: Mixed-ICH patients were younger (62.8±11.7 vs 71.0±14.5 in CAA) and showed a higher burden of vascular risk factors such as hypertension and diabetes than CAA-ICH (all p 〈 0.05). Patients with Mixed-ICH had lower mean global (1.11±0.2 vs 1.31±0.3), frontal (1.09±0.2 vs 1.31±0.3) and occipital SUVR (1.16±0.1 vs 1.32±0.2) than CAA-ICH (all p 〈 0.05). In multivariable analyses, Mixed-ICH diagnosis was associated with hypertension (β=-1.09, 95% Confidence interval [CI]: - 2.5- -0.1, p=0.02) while diagnosis of probable CAA with global-SUVR (β=3.5, CI: 0.3-7.3 p=0.04) after adjustment for age. Mean frontal and occipital-SUVR measures were both associated with probable CAA diagnosis in similar multivariable models. Compared to HTN-ICH, Mixed-ICH showed a similar mean age (62.8±11.7 vs 60±14.5 in HTN-ICH) and risk factor profile (all p 〉 0.1). Furthermore, mean global, frontal and occipital SUVR did not differ between Mixed ICH (values presented above) and HTN-ICH (1.08±0.1, 1.04±0.2 and 1.14±0.1 respectively, all p 〉 0.1). Conclusions: In addition to validating previous results in an Asian cohort, our study also brings the unique insight that Mixed-ICH patients have much lower amyloid load than CAA-ICH, while being very similar to HTN-ICH. Overall, Mixed-ICH is probably caused by HTN-SVD, an important conclusion with clinical relevance.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.49.suppl_1.WMP100
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
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  • 9
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    Abstract WP417: Relevance of Lobar Cerebral Microbleeds in Patients With Deep Intracerebral Hemorrhage
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Stroke Vol. 51, No. Suppl_1 ( 2020-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 51, No. Suppl_1 ( 2020-02)
    Abstract: Background: Markers of cerebral small vessel disease (cSVD) severity and prognosis in strictly lobar or strictly deep intracerebral hemorrhages (ICH)/cerebral microbleeds (CMB) are well defined but data are scarce for mixed-location ICH/CMB. We aimed to compare neuroimaging features and outcomes between deep ICH patients with and without lobar CMBs. Methods: Patients with first-ever deep ICH from a prospectively maintained single-center registry were analyzed. Demographics, risk factors and neuroimaging markers of cSVD including CMBs, cortical superficial siderosis, enlarged perivascular spaces (EPVS), white matter hyperintensity volumes (WMH) and brain atrophy scores (range 0-15) were compared between deep ICH patients with lobar CMBs and those without lobar CMBs. The follow-up data were analyzed for ICH recurrence, ischemic stroke (IS) and all-cause mortality. Results: Of 208 patients, 98 (47.1%) had lobar CMBs. Patients with L-CMBs were older (65.3±12.1 vs. 57.4±12.5, p 〈 0.001) and more likely to be hypertensive (98% vs. 90.9%, p=0.037) than those without L-CMBs. Deep CMBs (83.7% vs 56.4%, p 〈 0.001), lacunes (53.1% vs 31.8%, p=0.003) and severe basal ganglia EPVS (40.8% vs 17.3%, p 〈 0.001) were more common in patients with L-CMBs. Patients with L-CMBs had higher volumes of WMH (17.4 ml [IQR 9-38] vs 4.8 ml [IQR 1-13] , p 〈 0.001) and atrophy scores (4 [IQR 2-7] vs 3 [IQR 0-6] , p=0.007) as compared to patients without L-CMBs. During a median follow-up of 21 months, the ICH recurrence rate was similar between groups (p=0.2), but higher incident IS (3.0 vs 0.0 per 1000-person-months, p=0.016) and all-cause mortality (4.9 vs 1.5 per 1000-person-months, p=0.026) were observed in patients with L-CMBs. In a cox regression model, the presence of lobar CMBs was independently associated with a composite outcome measure (ICH/IS/mortality) after adjusting for age, hypertension, WMH volume, lacune, BG-EPVS and atrophy scores (odds ratio: 2.9, 95%CI:1.01-8.4 p=0.046). Conclusions: Presence of lobar CMBs in patients with deep ICH is associated with parenchymal markers of more severe cSVD and poor prognosis, suggesting a more advanced vasculopathy compared to patients with strictly deep ICH.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.51.suppl_1.WP417
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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  • 10
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    Distribution of Lacunar Infarcts in Asians With Intracerebral Hemorrhage : A Magnetic Resonance Imaging and Amyloid Positron Emission Tomography Study
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Stroke Vol. 49, No. 6 ( 2018-06), p. 1515-1517
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 49, No. 6 ( 2018-06), p. 1515-1517
    Abstract: We evaluated whether lacunes in centrum semiovale (lobar lacunes) were associated with cerebral amyloid angiopathy (CAA) markers in an Asian intracerebral hemorrhage (ICH) population. Methods— One hundred ten patients with primary ICH were classified as CAA-ICH (n=24; mean age, 70.9±13.9) or hypertensive ICH (n=86; mean age, 59.3±13.0) according to the presence of strictly lobar (per modified Boston criteria) or strictly deep bleeds (both ICH and cerebral microbleeds), respectively. Lacunes were evaluated in the supratentorial area and classified as lobar or classical deep based on the location. A subgroup of 36 patients also underwent Pittsburgh Compound B positron emission tomography to measure cerebral amyloid deposition and global standardized uptake value ratio were calculated. Results— Lobar lacunes were more frequent in CAA-ICH than hypertensive ICH (29.2 versus 11.6%; P =0.036). In multivariable models, lobar lacunes were associated with lobar cerebral microbleed (odds ratio, 6.8; 95% confidence interval, 1.6–29.9; P =0.011) after adjustment for age, sex, hypertension, and white matter hyperintensity. In 15 CAA-ICH and 21 hypertensive ICH patients with Pittsburgh Compound B positron emission tomography, correlation analyses between lobar lacune counts and global standardized uptake value ratio showed positive association (ρ=0.40; P =0.02) and remained significant after adjustment for age ( r =0.34; P =0.04). Conclusions— Our findings expand on recent work showing that lobar lacunes are more frequent in CAA-ICH than hypertensive ICH. Their independent association with lobar cerebral microbleeds and brain amyloid deposition suggests a relationship with CAA even in an Asian cohort with overall higher hypertensive load.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/STROKEAHA.118.021539
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
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