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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Long-Term Follow-Up of Cerebral Amyloid Angiopathy-Associated Intracranial Hemorrhage Reveals a High Prevalence of Atrial Fibrillation
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Long-Term Follow-Up of Cerebral Amyloid Angiopathy-Associated Intracranial Hemorrhage Reveals a High Prevalence of Atrial Fibrillation

机译：脑淀粉样血管病相关的颅内出血的长期随访显示心房颤动的高度普及

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Goal: Cerebral amyloid angiopathy (CAA) is the second-most common cause of nontraumatic intracerebral hemorrhages (ICH), surpassed only by uncontrolled hypertension. We characterized the percentage, risk factors, and comorbidities of patients suffering from CAA-related ICH in relation to long-term outcomes. Material and Methods: We performed retrospective analyses and clinical follow-ups of individuals suffering from ICH who were directly admitted to neurosurgery between 2002 and 2016. Findings: Seventy-four of 174 (42%) spontaneous nontraumatic lobar ICH cases leastwise satisfied the modified Boston criteria definition for at least "possible CAA." Females suffered a higher risk of CAA-caused ICH (42 of 74, 56.8%, P=.035). Atrial fibrillation as a major comorbidity was observed in 19 patients (25.7%). Recovery (decrease of modified Rankin scale [mRS]) was highest during hospitalization in the acute clinic. One-year mortality was as follows: 14 of 25 patients (56%) with probable CAA without supporting pathology, 6 of 18, and 8 of 31 patients with supporting pathology and possible CAA, respectively. Only 10 of 74 (13.6%) had favorable long-term outcomes (mRS <= 2). Increasing numbers of lobar hemorrhages, low initial Glasgow Coma Scale, and subarachnoid hemorrhage were significantly associated with poor survivability, whereas statins, antithrombotic agents, an intraventricular hemorrhage, and midline shift played seemingly minor roles. Conclusions: Symptomatic ICH is a serious stage in CAA progression with high mortality. The high incidence of concurrent atrial fibrillation in these patients may support data on more widespread vascular pathology in CAA.
机译：目标：脑淀粉样血管病（CAA）是非吸引性脑出血（ICH）的第二个最常见原因，仅通过不受控制的高血压超越。我们以与长期结果相关的CAA相关的ICH患者的百分比，危险因素和患者的百分比，危险因素和可融集性。材料和方法：我们对2002年至2016年之间直接录取的ICH的患者进行了回顾性分析和临床后续患者。结果：174（42％）的七十四分（42％）自发性非法型洛巴尔ICH案例最低满足修改后的波士顿至少“可能的CAA”的标准定义。女性患Caa导致的Ich风险更高（74,56.8％，p = .035）。在19名患者中观察到心房颤动作为主要的合并症（25.7％）。在急性诊所住院期间，恢复（改进的Rankin Scale [Mrs]的变化减少）最高。一年的死亡率如下：25名患者中的14例（56％），有可能的CAA，无支撑病理学，共18例，共有31名患者，其中8名患者的支持病理学和可能的CAA。只有74个（13.6％）只有10个有利的长期结果（夫人<= 2）。越来越多的叶片出血，低初始glasgow彗形标串和蛛网膜下腔出血具有显着的生存性显着相关，而他汀类药物，抗血栓形成剂，脑室内出血和中线转变起到了看似轻微的作用。结论：症状ICH是CAA进展的严重阶段，具有高死亡率。这些患者的同时性心房颤动的高发病率可能支持CAA中更广泛的血管病理学数据。

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