Impact of Cerebral Small Vessel Disease on Functional Recovery After Intracerebral Hemorrhage

Simone M Uniken Venema, Sandro Marini, Umme K Lena, Andrea Morotti, Michael Jessel, Charles J Moomaw, Christina Kourkoulis, Fernando D Testai, Steven J Kittner, H Bart Brouwers, Michael L James, Daniel Woo, Christopher D Anderson, Jonathan Rosand

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Abstract

Background and Purpose- In this study, we aim to investigate the association of computed tomography-based markers of cerebral small vessel disease with functional outcome and recovery after intracerebral hemorrhage. Methods- Computed tomographic scans of patients in the ERICH study (Ethnic and Racial Variations of Intracerebral Hemorrhage) were evaluated for the extent of leukoaraiosis and cerebral atrophy using visual rating scales. Poor functional outcome was defined as a modified Rankin Scale (mRS) of ≥3. Multivariable logistic and linear regression models were used to explore the associations of cerebral small vessel disease imaging markers with poor functional outcome at discharge and, as a measure of recovery, change in mRS from discharge to 90 days poststroke. Results- After excluding in-hospital deaths, data from 2344 patients, 583 (24.9%) with good functional outcome (mRS of 0-2) at discharge and 1761 (75.1%) with poor functional outcome (mRS of 3-5) at discharge, were included. Increasing extent of leukoaraiosis (P for trend, 0.01) and only severe (grade 4) global atrophy (odds ratio, 2.02; 95% CI, 1.22-3.39, P=0.007) were independently associated with poor functional outcome at discharge. Mean (SD) mRS change from discharge to 90-day follow-up was 0.57 (1.18). Increasing extent of leukoaraiosis (P for trend, 0.002) and severe global atrophy (β [SE], -0.23 [0.115]; P=0.045) were independently associated with less improvement in mRS from discharge to 90 days poststroke. Conclusions- In intracerebral hemorrhage survivors, the extent of cerebral small vessel disease at the time of intracerebral hemorrhage is associated with poor functional outcome at hospital discharge and impaired functional recovery from discharge to 90 days poststroke.

Original languageEnglish
Pages (from-to)2722-2728
Number of pages7
JournalStroke
Volume50
Issue number10
DOIs
Publication statusPublished - Oct 2019

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Cerebral Small Vessel Diseases
Leukoaraiosis
Cerebral Hemorrhage
Atrophy
Linear Models
Survivors
Logistic Models
Odds Ratio
Tomography

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Uniken Venema, S. M., Marini, S., Lena, U. K., Morotti, A., Jessel, M., Moomaw, C. J., ... Rosand, J. (2019). Impact of Cerebral Small Vessel Disease on Functional Recovery After Intracerebral Hemorrhage. Stroke, 50(10), 2722-2728. https://doi.org/10.1161/STROKEAHA.119.025061

Impact of Cerebral Small Vessel Disease on Functional Recovery After Intracerebral Hemorrhage. / Uniken Venema, Simone M; Marini, Sandro; Lena, Umme K; Morotti, Andrea; Jessel, Michael; Moomaw, Charles J; Kourkoulis, Christina; Testai, Fernando D; Kittner, Steven J; Brouwers, H Bart; James, Michael L; Woo, Daniel; Anderson, Christopher D; Rosand, Jonathan.

In: Stroke, Vol. 50, No. 10, 10.2019, p. 2722-2728.

Research output: Contribution to journalArticle

Uniken Venema, SM, Marini, S, Lena, UK, Morotti, A, Jessel, M, Moomaw, CJ, Kourkoulis, C, Testai, FD, Kittner, SJ, Brouwers, HB, James, ML, Woo, D, Anderson, CD & Rosand, J 2019, 'Impact of Cerebral Small Vessel Disease on Functional Recovery After Intracerebral Hemorrhage', Stroke, vol. 50, no. 10, pp. 2722-2728. https://doi.org/10.1161/STROKEAHA.119.025061
Uniken Venema, Simone M ; Marini, Sandro ; Lena, Umme K ; Morotti, Andrea ; Jessel, Michael ; Moomaw, Charles J ; Kourkoulis, Christina ; Testai, Fernando D ; Kittner, Steven J ; Brouwers, H Bart ; James, Michael L ; Woo, Daniel ; Anderson, Christopher D ; Rosand, Jonathan. / Impact of Cerebral Small Vessel Disease on Functional Recovery After Intracerebral Hemorrhage. In: Stroke. 2019 ; Vol. 50, No. 10. pp. 2722-2728.
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T1 - Impact of Cerebral Small Vessel Disease on Functional Recovery After Intracerebral Hemorrhage

AU - Uniken Venema, Simone M

AU - Marini, Sandro

AU - Lena, Umme K

AU - Morotti, Andrea

AU - Jessel, Michael

AU - Moomaw, Charles J

AU - Kourkoulis, Christina

AU - Testai, Fernando D

AU - Kittner, Steven J

AU - Brouwers, H Bart

AU - James, Michael L

AU - Woo, Daniel

AU - Anderson, Christopher D

AU - Rosand, Jonathan

PY - 2019/10

Y1 - 2019/10

N2 - Background and Purpose- In this study, we aim to investigate the association of computed tomography-based markers of cerebral small vessel disease with functional outcome and recovery after intracerebral hemorrhage. Methods- Computed tomographic scans of patients in the ERICH study (Ethnic and Racial Variations of Intracerebral Hemorrhage) were evaluated for the extent of leukoaraiosis and cerebral atrophy using visual rating scales. Poor functional outcome was defined as a modified Rankin Scale (mRS) of ≥3. Multivariable logistic and linear regression models were used to explore the associations of cerebral small vessel disease imaging markers with poor functional outcome at discharge and, as a measure of recovery, change in mRS from discharge to 90 days poststroke. Results- After excluding in-hospital deaths, data from 2344 patients, 583 (24.9%) with good functional outcome (mRS of 0-2) at discharge and 1761 (75.1%) with poor functional outcome (mRS of 3-5) at discharge, were included. Increasing extent of leukoaraiosis (P for trend, 0.01) and only severe (grade 4) global atrophy (odds ratio, 2.02; 95% CI, 1.22-3.39, P=0.007) were independently associated with poor functional outcome at discharge. Mean (SD) mRS change from discharge to 90-day follow-up was 0.57 (1.18). Increasing extent of leukoaraiosis (P for trend, 0.002) and severe global atrophy (β [SE], -0.23 [0.115]; P=0.045) were independently associated with less improvement in mRS from discharge to 90 days poststroke. Conclusions- In intracerebral hemorrhage survivors, the extent of cerebral small vessel disease at the time of intracerebral hemorrhage is associated with poor functional outcome at hospital discharge and impaired functional recovery from discharge to 90 days poststroke.

AB - Background and Purpose- In this study, we aim to investigate the association of computed tomography-based markers of cerebral small vessel disease with functional outcome and recovery after intracerebral hemorrhage. Methods- Computed tomographic scans of patients in the ERICH study (Ethnic and Racial Variations of Intracerebral Hemorrhage) were evaluated for the extent of leukoaraiosis and cerebral atrophy using visual rating scales. Poor functional outcome was defined as a modified Rankin Scale (mRS) of ≥3. Multivariable logistic and linear regression models were used to explore the associations of cerebral small vessel disease imaging markers with poor functional outcome at discharge and, as a measure of recovery, change in mRS from discharge to 90 days poststroke. Results- After excluding in-hospital deaths, data from 2344 patients, 583 (24.9%) with good functional outcome (mRS of 0-2) at discharge and 1761 (75.1%) with poor functional outcome (mRS of 3-5) at discharge, were included. Increasing extent of leukoaraiosis (P for trend, 0.01) and only severe (grade 4) global atrophy (odds ratio, 2.02; 95% CI, 1.22-3.39, P=0.007) were independently associated with poor functional outcome at discharge. Mean (SD) mRS change from discharge to 90-day follow-up was 0.57 (1.18). Increasing extent of leukoaraiosis (P for trend, 0.002) and severe global atrophy (β [SE], -0.23 [0.115]; P=0.045) were independently associated with less improvement in mRS from discharge to 90 days poststroke. Conclusions- In intracerebral hemorrhage survivors, the extent of cerebral small vessel disease at the time of intracerebral hemorrhage is associated with poor functional outcome at hospital discharge and impaired functional recovery from discharge to 90 days poststroke.

U2 - 10.1161/STROKEAHA.119.025061

DO - 10.1161/STROKEAHA.119.025061

M3 - Article

VL - 50

SP - 2722

EP - 2728

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 10

ER -