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Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
[Lobar intracerebral hemorhages: a clinical study in 97 patients]
1Unidad de Patología Vascular Cerebral, Servicio de Neurología, Hospital Universitari del Sagrat Cor, Universitat de Barcelona, Barcelona, España. aarboix@hscor.com
Insights
Lobar hemorrhages (LH) represent one-third of all intracerebral hemorrhages. This study identified distinct clinical features and risk factors for LH, differing from subcortical hemorrhages.
Area of Science:
- Neurology
- Stroke Research
- Cerebrovascular Diseases
Context:
- Lobar hemorrhages (LH) constitute a significant proportion of intracerebral hemorrhages.
- Understanding the specific characteristics of LH is crucial for effective diagnosis and management.
- Previous studies have often grouped different types of intracerebral hemorrhages, potentially obscuring unique LH features.
Purpose:
- To characterize the clinical features, etiology, and prognosis of lobar hemorrhages (LH).
- To compare vascular risk factors and clinical profiles of patients with LH versus those with subcortical hemorrhages.
- To identify independent predictors of LH.
Summary:
- Lobar hemorrhages (LH) accounted for 35.9% of all intracerebral hemorrhages in a 12-year study.
- The most common causes included arterial hypertension (41%) and vascular malformations (8.5%).
- Independent predictors for LH included early seizures, headache, and female sex, while sensory deficit and hypertension were protective.
Impact:
- The findings highlight that one in three intracerebral hemorrhages are lobar hemorrhages.
- Identification of distinct risk factors and clinical profiles for LH compared to subcortical hemorrhages.
- Provides valuable insights for targeted prevention and treatment strategies for lobar hemorrhages.
Background And Objective:
We aimed to characterize the clinical features,etiology and prognosis in lobar hemorrhages (LH).
Patients And Method:
Descriptive study of 97 patients with LH included in the Sagrat Cor Hospital of Barcelona Stroke Registry over a 12 year period. The vascular risk factors and clinical profiles in a LH group and a subcortical hemorrhage group (n = 92) were compared.
Results:
LH accounted for 3.9% of all acute strokes (n = 2,500) and 35.9% of all intracerebral hemorrhages. The parietal lobe was the most frequent cerebral topography (45.4%). LH were caused by arterial hypertension in 41% of patients, vascular malformations in 8.5%, bleeding diathesis in 5.5% and anticoagulation in 3%. The overall in-hospital mortality rate was 26.8%. Early seizures (odds ratio [OR] = 5.41; confidence interval [CI] 95%, 1.06-27.69), headache (OR = 2.19; CI 95%, 1.13-4.26), female sex (OR = 1.97; CI 95%, 1.04-3.75), sensory deficit (OR = 0.41; CI 95%, 0.22-0.77) and hypertension (OR = 0.34; CI 95%, 0.18-0.65) were independent predictors of LH.
Conclusions:
One in every 3 intracerebral hemorrhages is a LH. Different potentially modifiable vascular risk factors and clinical profiles were identified in LH versus subcortical hemorrhages.
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