Intracranial atherosclerosis and cerebral small vessel disease in intracerebral hemorrhage patients

Gregoire Boulouis, Andreas Charidimou, Eitan Auriel, Kellen E. Haley, Ellis S. van Etten, Panagiotis Fotiadis, Yael Reijmer, Alison Ayres, Kristin M. Schwab, Sergi Martinez-Ramirez, Jonathan Rosand, Anand Viswanathan, Joshua N. Goldstein, Steven M. Greenberg, M. Edip Gurol*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background The association between cerebral small vessel diseases (cSVD) and intracranial atherosclerosis is debated and conflicting results have been reported. We sought to investigate this association in patients with intracerebral hemorrhage (ICH), due to severe cSVD. Methods Consecutive ICH patients were divided into those meeting criteria for cerebral amyloid angiopathy (CAA) and those with deep hypertensive ICH consistent with hypertensive cSVD (HTN-SVD). White matter hyperintensity volumes (WMH) and microbleed counts (MB) were measured on MRI. CTA was rated for severity of intracranial carotid calcifications and for presence of > 50% intracranial stenosis (ICS). Associations of intracranial atherosclerosis severity with type of SVD (CAA vs HTN-cSVD) and with imaging and clinical markers of cSVD burden were analyzed. Results The cohort included 253 CAA and 90 HTN-SVD patients. In multivariable models, the type of cSVD (CAA vs. HTN-cSVD) was not associated with calcification severity (OR = 1.04, 95% CI [0.62–3.5], p = 0.37) or presence of ICS (OR = 0.84, 95% CI [0.21–2.74], p = 0.78). We found no association between intracranial atherosclerosis (calcifications and stenoses) and parenchymal markers of cSVD severity (WMH and MB, adjusted p ≥ 0.2 for all comparisons) and no association with presence of dementia before ICH (adjusted p ≥ 0.2 for both comparisons). Conclusions We found no association between intracranial atherosclerosis and parenchymal or clinical consequences of cSVD, suggesting that cSVDs while sharing some risk factors are not influenced by upstream larger vessel pathologies.

Original languageEnglish
Pages (from-to)324-329
Number of pages6
JournalJournal of the Neurological Sciences
Volume369
DOIs
StatePublished - 15 Oct 2016
Externally publishedYes

Keywords

  • Atherosclerosis
  • CT angiography
  • Carotid
  • Intracerebral hemorrhage
  • Small vessel disease

Fingerprint

Dive into the research topics of 'Intracranial atherosclerosis and cerebral small vessel disease in intracerebral hemorrhage patients'. Together they form a unique fingerprint.

Cite this