TY  - BOOK
AU  - Fernandez, Stephen J
AU  - Kidwell, Chelsea S
AU  - Menon, Ravi S
AU  - Shara, Nawar M
TI  - Predictors of highly prevalent brain ischemia in intracerebral hemorrhage
SN  - 0364-5134
KW  - *Brain Ischemia/ep [Epidemiology]
KW  - *Brain Ischemia/pp [Physiopathology]
KW  - *Cerebral Hemorrhage/ep [Epidemiology]
KW  - *Cerebral Hemorrhage/pp [Physiopathology]
KW  - Acute Disease
KW  - African Continental Ancestry Group
KW  - Aged
KW  - Brain Ischemia/co [Complications]
KW  - Cerebral Hemorrhage/co [Complications]
KW  - Comorbidity
KW  - Diffusion Magnetic Resonance Imaging
KW  - Female
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Predictive Value of Tests
KW  - Prevalence
KW  - Prospective Studies
KW  - Risk Factors
KW  - Severity of Illness Index
KW  - Time Factors
KW  - United States
KW  - MedStar Health Research Institute
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Neurology
KW  - Journal Article
KW  - Research Support, N.I.H., Extramural
N1  - Available online from MWHC library: 1996 - present
N2  - INTERPRETATION: This study demonstrates that >1/3 of patients with primary ICH have active cerebral ischemia at baseline remote from the index hematoma, and 1/4 of patients experience ongoing, acute ischemic events at 1 month. Multivariate analyses implicate blood pressure reductions in the setting of an active vasculopathy as a potential underlying mechanism. Further studies are needed to determine the impact of these lesions on outcome and optimal management strategies to arrest vascular damage. Copyright  2012 American Neurological Association; METHODS: Patients were recruited within a prospective, longitudinal, magnetic resonance imaging (MRI)-based study of primary ICH. Clinical, demographic, and MRI data were collected on all subjects at baseline and 1 month; OBJECTIVE: This study was undertaken to determine the prevalence, characteristics, risk factors, and temporal profile of concurrent ischemic lesions in patients with acute primary intracerebral hemorrhage (ICH); RESULTS: Of the 138 patients enrolled, mean age was 59 years, 54% were male, 73% were black, and 84% had a history of hypertension. At baseline, ischemic lesions on diffusion-weighted imaging (DWI) were found in 35% of patients. At 1 month, lesions were present in 27%, and of these lesions, 83% were new and not present at baseline. ICH volume (p = 0.025), intraventricular hemorrhage (p = 0.019), presence of microbleeds (p = 0.024), and large, early reductions in mean arterial pressure (p = 0.003) were independent predictors of baseline DWI lesions. A multivariate logistical model predicting the presence of 1-month DWI lesions included history of any prior stroke (p = 0.012), presence of 1 or more microbleeds (p = 0.04), black race (p = 0.641), and presence of a DWI lesion at baseline (p = 0.007)
UR  - http://dx.doi.org/10.1002/ana.22668
ER  -