Impact of brain atrophy on 90-day functional outcome after moderate-volume basal ganglia hemorrhage

Kwon, Sae Min; Choi, Kyu-Sun; Yi, Hyeong-Joong; Ko, Yong; Kim, Youngsoo; Bak, Koang-Hum; Hu, Chun; Lee, Young-Jun; Lee, Ji Young

doi:10.1038/s41598-018-22916-3

Cited by 31 publications

(28 citation statements)

References 24 publications

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“…In contrast, cerebral atrophy was associated with a good 90-day functional outcome in one small study. 16 This conflicting result probably relates to differences in participant selection, as this study included a very specific subgroup of participants with moderate volume basal ganglia ICH. 16 In our study, we included all patients with ICH regardless of pre-ICH dependence, ICH location, and ICH severity.…”

Section: Discussionmentioning

confidence: 96%

“…11,12 White matter lucencies (WMLs) on brain computed tomography (CT) were associated with poor 28-and 90-day functional outcome and 90-day death after SVD-ICH in a recent meta-analysis of 9 studies, which may have been affected by selection bias. 13 Less is known about the association of not only WMLs but also other individual CT SVD biomarkers (such as lacunes and cerebral atrophy [14][15][16] ) with longer-term outcomes after SVD-ICH. Composite SVD-burden scores have shown added prognostic value over individual SVD biomarkers in other settings 11,[17][18][19][20][21] ; however, the association of the CT SVD score 22 with SVD-ICH outcome is unknown.…”

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confidence: 99%

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Association between Computed Tomographic Biomarkers of Cerebral Small Vessel Diseases and Long‐Term Outcome after Spontaneous Intracerebral Hemorrhage

Rodrigues

Samarasekera

Lerpiniere

et al. 2020

Annals of Neurology

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Objective A study was undertaken to assess whether cerebral small vessel disease (SVD) computed tomographic (CT) biomarkers are associated with long‐term outcome after intracerebral hemorrhage. Methods We performed a prospective, community‐based cohort study of adults diagnosed with spontaneous intracerebral hemorrhage between June 1, 2010 and May 31, 2013. A neuroradiologist rated the diagnostic brain CT for acute intracerebral hemorrhage features and SVD biomarkers. We used severity of white matter lucencies and cerebral atrophy, and the number of lacunes to calculate the CT SVD score. We assessed the association between CT SVD biomarkers and either death, or death or dependence (modified Rankin Scale scores = 4–6) 1 year after first‐ever intracerebral hemorrhage using logistic regression, adjusting for known predictors of outcome. Results Within 1 year of intracerebral hemorrhage, 224 (56%) of 402 patients died. In separate models, 1‐year death was associated with severe atrophy (adjusted odds ratio [aOR] = 2.54, 95% confidence interval [CI] = 1.44–4.49, p = 0.001) but not lacunes or severe white matter lucencies, and CT SVD sum score ≥ 1 (aOR = 2.50, 95% CI = 1.40–4.45, p = 0.002). Two hundred seventy‐seven (73%) of 378 patients with modified Rankin Scale data were dead or dependent at 1 year. In separate models, 1‐year death or dependence was associated with severe atrophy (aOR = 3.67, 95% CI = 1.71–7.89, p = 0.001) and severe white matter lucencies (aOR = 2.18, 95% CI = 1.06–4.51, p = 0.035) but not lacunes, and CT SVD sum score ≥ 1 (aOR = 2.81, 95% CI = 1.45–5.46, p = 0.002). Interpretation SVD biomarkers on the diagnostic brain CT are associated with 1‐year death and dependence after intracerebral hemorrhage, independent of known predictors of outcome. ANN NEUROL 2021;89:266–279

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Section: Discussionmentioning

confidence: 96%

mentioning

confidence: 99%

Association between Computed Tomographic Biomarkers of Cerebral Small Vessel Diseases and Long‐Term Outcome after Spontaneous Intracerebral Hemorrhage

Rodrigues

Samarasekera

Lerpiniere

et al. 2020

Annals of Neurology

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“…Epidemiological studies have shown that China had the highest incidence of hemorrhagic stroke worldwide,15 with an estimated morbidity of 114.8 to 159.8 per 100 000 person-years 16. Deep-seated basal ganglia hemorrhage is the most common region of spontaneous ICH, causing death or dependency in more than 70% of affected patients 17…”

Section: Discussionmentioning

confidence: 99%

Comparison of endoscopic evacuation, stereotactic aspiration, and craniotomy for treatment of basal ganglia hemorrhage

Guo

Liu

Zhang

et al. 2019

J NeuroIntervent Surg

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BackgroundThe main surgical techniques for spontaneous basal ganglia hemorrhage include stereotactic aspiration, endoscopic aspiration, and craniotomy. However, credible evidence is still needed to validate the effect of these techniques.ObjectiveTo explore the long-term outcomes of the three surgical techniques in the treatment of spontaneous basal ganglia hemorrhage.MethodsFive hundred and sixteen patients with spontaneous basal ganglia hemorrhage who received stereotactic aspiration, endoscopic aspiration, or craniotomy were reviewed retrospectively. Six-month mortality and the modified Rankin Scale score were the primary and secondary outcomes, respectively. A multivariate logistic regression model was used to assess the effects of different surgical techniques on patient outcomes.ResultsFor the entire cohort, the 6-month mortality in the endoscopic aspiration group was significantly lower than that in the stereotactic aspiration group (odds ratio (OR) 4.280, 95% CI 2.186 to 8.380); the 6-month mortality in the endoscopic aspiration group was lower than that in the craniotomy group, but the difference was not significant (OR=1.930, 95% CI 0.835 to 4.465). A further subgroup analysis was stratified by hematoma volume. The mortality in the endoscopic aspiration group was significantly lower than in the stereotactic aspiration group in the medium (≥40–<80 mL) (OR=2.438, 95% CI 1.101 to 5.402) and large hematoma subgroup (≥80 mL) (OR=66.532, 95% CI 6.345 to 697.675). Compared with the endoscopic aspiration group, a trend towards increased mortality was observed in the large hematoma subgroup of the craniotomy group (OR=8.721, 95% CI 0.933 to 81.551).ConclusionEndoscopic aspiration can decrease the 6-month mortality of spontaneous basal ganglia hemorrhage, especially in patients with a hematoma volume ≥40 mL.

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“…The typical regions of sICH are the deep gray matter structures, including the basal ganglia and thalamus (1). sICH in these regions causes death or dependency in more than 70% of patients (19).…”

Section: Discussionmentioning

confidence: 99%

Long-Term Effect of Endoscopic Evacuation for Large Basal Ganglia Hemorrhage With GCS Scores ≦ 8

Liu

Zhang

et al. 2020

Front. Neurol.

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The surgical evacuation, including stereotactic aspiration, endoscopic evacuation, and craniotomy, is the most effective way to reduce the volume of intracerebral hemorrhage. However, credible evidence for the effects of these techniques is still insufficient. The present study explored the long-term outcomes of these techniques in the treatment of basal ganglia hematoma with low Glasgow Coma Scale (GCS) scores (≤8) and large-volume (≥40 ml), which were predictors of high mortality. Methods: Two hundred and fifty-eight consecutive patients were reviewed retrospectively. The primary and secondary outcomes were 6-months mortality and 6-months modified Rankin Scale score, which were assessed by a multivariate logistic regression model. Results: Compared with the endoscopic evacuation group, the mortality was significantly higher in the stereotactic aspiration group (OR 6.858, 95% CI 3.146-14.953) and open craniotomy group (OR 3.315, 95% CI 1.497-7.341). Age (OR = 2.237, 95% CI 1.290-3.877) and herniation (OR = 2.257, 95% CI 1.172-4.348) were independent predictors for mortality. No significant difference in the neurological functional outcome was found in the stereotactic aspiration group (OR 0.501, 95% CI 0.192-1.308) and the craniotomy group (OR 0.774, 95% CI 0.257-2.335) compared with the endoscopic evacuation group. Conclusion: Endoscopic evacuation significantly decreased the 6-months mortality in patients with hemorrhage ≥40 ml and GCS ≤ 8.

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Impact of brain atrophy on 90-day functional outcome after moderate-volume basal ganglia hemorrhage

Cited by 31 publications

References 24 publications

Association between Computed Tomographic Biomarkers of Cerebral Small Vessel Diseases and Long‐Term Outcome after Spontaneous Intracerebral Hemorrhage

Association between Computed Tomographic Biomarkers of Cerebral Small Vessel Diseases and Long‐Term Outcome after Spontaneous Intracerebral Hemorrhage

Comparison of endoscopic evacuation, stereotactic aspiration, and craniotomy for treatment of basal ganglia hemorrhage

Long-Term Effect of Endoscopic Evacuation for Large Basal Ganglia Hemorrhage With GCS Scores ≦ 8

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