TY - JOUR
T1 - Characteristic distributions of intracerebral hemorrhage-Associated diffusion-weighted lesions
AU - Auriel, Eitan
AU - Gurol, Mahmut Edip
AU - Ayres, Alison
AU - Dumas, Andrew P.
AU - Schwab, Kristin M.
AU - Vashkevich, Anastasia
AU - Martinez-Ramirez, Sergi
AU - Rosand, Jonathan
AU - Viswanathan, Anand
AU - Greenberg, Steven M.
N1 - Funding Information:
E. Auriel, M.E. Gurol, A. Ayres, A.P. Dumas, K.M. Schwab, A. Vashkevich, and S. Martinez-Ramirez report no disclosures. J. Rosand receives research support from the NIH and American Heart Association. A. Viswanathan reports no disclosures. S.M. Greenberg receives research support from the NIH and serves as consultant and on the advisory board of Hoffman-La Roche. Go to Neurology.org for full disclosures.
Funding Information:
Study funding: All funding entities had no involvement in study design, data collection, analysis, and interpretation, writing of the manuscript, or in the decision to submit for publication. The project described was supported by grant R01AG026484 from the National Institutes of Health .
PY - 2012/12/11
Y1 - 2012/12/11
N2 - Objectives: To determine whether small diffusion-weighted imaging (DWI) lesions occur beyond the acute posthemorrhage time window in patients with intracerebral hemorrhage (ICH) and to characterize their spatial distribution in patients with lobar and deep cerebral hemorrhages. Methods: In this cross-sectional study, we retrospectively analyzed 458 MRI scans obtained in the acute (≤7 days after ICH) or nonacute (>14 days after ICH) phases from 392 subjects with strictly lobar (n = 276) and deep (n = 116) ICH (48.7% women; mean age 72.8 ± 11.7 years). DWI, apparent diffusion coefficient maps, fluid-Attenuated inversion recovery, and T2* MRIs were reviewed for the presence and location of DWI lesions. Results: We identified 103 DWI hyperintense lesions on scans from 62 subjects, located mostly in lobar brain regions (90 of 103, 87.4%). The lesions were not uniformly distributed throughout the brain lobes; patients with strictly lobar ICH had relative overrepresentation of lesions in frontal lobe, and patients with deep ICH in parietal lobe (p = 0.002). Although the frequency of DWI lesions tended to be greater on scans performed within 7 days after ICH (39 of 214, 18.2%), they continued at high frequency in the nonacute period as well (23 of 178, 12.9%, odds ratio 1.5, 95% confidence interval 0.86-2.6 for acute vs nonacute). There was also no difference in frequency of lesions on acute and nonacute scans among 66 subjects with MRIs in both time periods (8 of 66 acute, 10 of 66 nonacute, odds ratio 0.77, 95% confidence interval 0.25-2.4). Conclusions: The high frequency of DWI lesions beyond the acute post-ICH period and their characteristic distributions suggest that they are products of the small vessel diseases that underlie ICH.
AB - Objectives: To determine whether small diffusion-weighted imaging (DWI) lesions occur beyond the acute posthemorrhage time window in patients with intracerebral hemorrhage (ICH) and to characterize their spatial distribution in patients with lobar and deep cerebral hemorrhages. Methods: In this cross-sectional study, we retrospectively analyzed 458 MRI scans obtained in the acute (≤7 days after ICH) or nonacute (>14 days after ICH) phases from 392 subjects with strictly lobar (n = 276) and deep (n = 116) ICH (48.7% women; mean age 72.8 ± 11.7 years). DWI, apparent diffusion coefficient maps, fluid-Attenuated inversion recovery, and T2* MRIs were reviewed for the presence and location of DWI lesions. Results: We identified 103 DWI hyperintense lesions on scans from 62 subjects, located mostly in lobar brain regions (90 of 103, 87.4%). The lesions were not uniformly distributed throughout the brain lobes; patients with strictly lobar ICH had relative overrepresentation of lesions in frontal lobe, and patients with deep ICH in parietal lobe (p = 0.002). Although the frequency of DWI lesions tended to be greater on scans performed within 7 days after ICH (39 of 214, 18.2%), they continued at high frequency in the nonacute period as well (23 of 178, 12.9%, odds ratio 1.5, 95% confidence interval 0.86-2.6 for acute vs nonacute). There was also no difference in frequency of lesions on acute and nonacute scans among 66 subjects with MRIs in both time periods (8 of 66 acute, 10 of 66 nonacute, odds ratio 0.77, 95% confidence interval 0.25-2.4). Conclusions: The high frequency of DWI lesions beyond the acute post-ICH period and their characteristic distributions suggest that they are products of the small vessel diseases that underlie ICH.
UR - http://www.scopus.com/inward/record.url?scp=84871302239&partnerID=8YFLogxK
U2 - 10.1212/WNL.0b013e318278b66f
DO - 10.1212/WNL.0b013e318278b66f
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C2 - 23197745
AN - SCOPUS:84871302239
SN - 0028-3878
VL - 79
SP - 2335
EP - 2341
JO - Neurology
JF - Neurology
IS - 24
ER -