Contralateral Hemispheric Brain Atrophy After Primary Intracerebral Hemorrhage

In patients with intracerebral hematoma (ICH), it is well known that brain atrophy occurs in the hemisphere ipsilateral to the hematoma. The present study aimed to investigate contralateral hemispheric volume changes in patients with ICH as well as related factors.

Of 112 patients with ICH who were surgically treated at our hospital between January 2011 and December 2015, 44 were included in the present study. We measured contralateral hemispheric brain areas in 3 planes of axial brain computed tomography images. We obtained the proportion of contralateral hemispheric parenchyma to the hemispheric intracranial area to adjust for individual differences in head size. We analyzed the relationship between various factors and volume changes in the contralateral hemisphere.

The average volume percentages of preoperative and follow-up contralateral hemispheric parenchyma were 92.3% versus 88.8%, 90.3% versus 85.3%, and 86.9% versus 82.5% in the level of foramen of Monro, septum pellucidum, and lateral ventricle, respectively. These decreases were all statistically significant (paired t-test; P < 0.001). As far as the causes of these decreases, the presence of intraventricular hematoma was the most significant factor for a decrease (P = 0.006). Glasgow coma scale score on arrival, as well as, smoking were independent factors in a multivariate analysis (P = 0.016, 0.039).

Contralateral parenchymal volumes were significantly decreased at the 3-month follow-up brain computed tomography scan. These findings may offer important clinical information on the remote brain injury of ICH.