Predictors of highly prevalent brain ischemia in intracerebral hemorrhage
dc.contributor.author | Menon, Ravi S. | en_US |
dc.contributor.author | Burgess, Richard E. | en_US |
dc.contributor.author | Wing, Jeffrey J. | en_US |
dc.contributor.author | Gibbons, Michael C. | en_US |
dc.contributor.author | Shara, Nawar M. | en_US |
dc.contributor.author | Fernandez, Stephen | en_US |
dc.contributor.author | Jayam‐trouth, Annapurni | en_US |
dc.contributor.author | German, Laura | en_US |
dc.contributor.author | Sobotka, Ian | en_US |
dc.contributor.author | Edwards, Dorothy | en_US |
dc.contributor.author | Kidwell, Chelsea S. | en_US |
dc.date.accessioned | 2012-03-16T15:57:51Z | |
dc.date.available | 2013-04-01T14:17:23Z | en_US |
dc.date.issued | 2012-02 | en_US |
dc.identifier.citation | Menon, Ravi S.; Burgess, Richard E.; Wing, Jeffrey J.; Gibbons, M. Christopher; Shara, Nawar M.; Fernandez, Stephen; Jayam‐trouth, Annapurni ; German, Laura; Sobotka, Ian; Edwards, Dorothy; Kidwell, Chelsea S. (2012). "Predictors of highly prevalent brain ischemia in intracerebral hemorrhage." Annals of Neurology 71(2): 199-205. <http://hdl.handle.net/2027.42/90250> | en_US |
dc.identifier.issn | 0364-5134 | en_US |
dc.identifier.issn | 1531-8249 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/90250 | |
dc.description.abstract | 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). 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. 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). Interpretation: This study demonstrates that >⅓ of patients with primary ICH have active cerebral ischemia at baseline remote from the index hematoma, and ¼ 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. Ann Neurol 2012;71:199–205 | en_US |
dc.publisher | Wiley Subscription Services, Inc., A Wiley Company | en_US |
dc.title | Predictors of highly prevalent brain ischemia in intracerebral hemorrhage | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Psychiatry | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of Biostatistics, University of Michigan, Ann Arbor, MI | en_US |
dc.contributor.affiliationother | Medstar Health Research Institute, Hyattsville, MD | en_US |
dc.contributor.affiliationother | Department of Neurology and Stroke Center, Georgetown University, Washington, DC | en_US |
dc.contributor.affiliationother | Johns Hopkins University Urban Health Institute, Baltimore, MD | en_US |
dc.contributor.affiliationother | Department of Neurology, Howard University, Washington, DC | en_US |
dc.contributor.affiliationother | Departments of Kinesiology and Neurology, University of Wisconsin, Madison, WI | en_US |
dc.contributor.affiliationother | Department of Neurology, Georgetown University, 4000 Reservoir Road, Suite 150, Washington, DC 20007 | en_US |
dc.identifier.pmid | 22367992 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/90250/1/22668_ftp.pdf | |
dc.identifier.doi | 10.1002/ana.22668 | en_US |
dc.identifier.source | Annals of Neurology | en_US |
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dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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