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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >White Matter Lesion Severity is Associated with Intraventricular Hemorrhage in Spontaneous Intracerebral Hemorrhage
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White Matter Lesion Severity is Associated with Intraventricular Hemorrhage in Spontaneous Intracerebral Hemorrhage

机译：白质病变严重程度与自发脑出血中的腔内出血有关

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Background: Intraventricular hemorrhage (IVH) and white matter lesion (WML) severity are associated with higher rates of death and disability in intracerebral hemorrhage (ICH). A prior report identified an increased risk of IVH with greater WML burden but did not control for location of ICH. We sought to determine whether a higher degree of WML is associated with a higher risk of IVH after controlling for ICH location. Methods: Utilizing the patient population from 2 large ICH studies; the Genetic and Environmental Risk Factors for Hemorrhagic Stroke (GERFHS III) Study and the Ethnic/Racial Variations of Intracerebral Hemorrhage study, we graded WML using the Van Swieten Scale (0-1 for mild, 2 for moderate, and 3-4 for severe WML) and presence or absence of IVH in baseline CT scans. We used multivariable regression models to adjust for relevant covariates. Results: Among 3023 ICH patients, 1260 (41.7%) had presence of IVH. In patients with IVH, the proportion of severe WML (28.6%) was higher compared with patients without IVH (21.8%) (P < .0001). Multivariable analysis demonstrated that moderate-severe WML, deep ICH, and increasing ICH volume were independently associated with presence of IVH. We found an increased risk of IVH with moderate-severe WML (OR = 1.38; 95%Cl 1.03-1.86, P = .0328) in the subset of lobar hemorrhages. Conclusions: Moderate to severe WML is a risk for IVH. Even in lobar ICH hemorrhages, severe WML leads to an independent increased risk for ventricular rupture.
机译：背景：脑室内出血（IVH）和脑白质病变（WML）的严重程度与脑出血（ICH）中较高的死亡率和致残率相关。之前的一份报告指出，IVH风险增加，WML负担加重，但没有控制ICH的位置。在控制ICH位置后，我们试图确定WML程度越高是否与IVH风险越高相关。方法：利用2项大型ICH研究中的患者群体；在出血性卒中的遗传和环境风险因素（GERFHS III）研究和脑出血的种族/种族差异研究中，我们使用Van Swieten量表（轻度0-1，中度2，重度3-4）和基线CT扫描中是否存在IVH对WML进行分级。我们使用多变量回归模型调整相关协变量。结果：在3023例脑出血患者中，1260例（41.7%）存在IVH。在IVH患者中，重度WML的比例（28.6%）高于非IVH患者（21.8%）（P<0.0001）。多变量分析表明，中重度WML、深部ICH和ICH体积增加与IVH的存在独立相关。我们发现在大叶出血亚组中，中重度WML（OR=1.38；95%Cl 1.03-1.86，P=0.0328）患者发生IVH的风险增加。结论：中重度WML是IVH的危险因素。即使在大叶脑出血中，严重的WML也会导致心室破裂的独立风险增加。

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