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Updated: Oct 13, 2026
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Total small vessel disease score and functional outcomes following acute intracerebral hemorrhage
Yoko Kimura1, Kaori Miwa2, Junji Takasugi3
1Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan.
Insights
The cumulative burden of small vessel disease (SVD) may predict poor outcomes after intracerebral hemorrhage (ICH). A higher SVD score indicates a greater risk of worse functional recovery following ICH.
Area of Science:
- Neurology
- Radiology
- Vascular Neurology
Background:
- Cerebral small vessel disease (SVD) markers are known predictors of poor prognosis after intracerebral hemorrhage (ICH).
- The cumulative impact of SVD burden on patient outcomes following ICH requires further investigation.
Purpose of the Study:
- To investigate the association between the global SVD burden and functional outcomes in patients with ICH.
- To determine if a cumulative SVD score can predict poor functional outcomes after ICH.
Main Methods:
- Retrospective analysis of 144 patients with ICH who underwent brain MRI and MRA.
- Calculation of a modified total SVD score (0-4) based on SVD markers (cerebral microbleeds, lacunar infarctions, periventricular and deep white matter hyperintensities).
- Multivariate logistic regression analysis to assess the association between SVD score and poor functional outcomes (modified Rankin Scale score ≥ 3).
Main Results:
- The modified total SVD score showed a potential association with poor functional outcomes (OR 1.72, 95% CI 0.97-3.03) after adjusting for clinical factors.
- In older patients (≥ 65 years), the SVD score was significantly associated with poor outcomes (OR 3.11, 95% CI 1.01-9.55).
- The SVD score remained significant for predicting poor outcomes in patients with supratentorial ICH (OR 2.06, 95% CI 1.11-3.83).
Conclusions:
- The modified total SVD score may serve as a valuable predictive tool for poor functional outcomes after intracerebral hemorrhage.
- Assessing the cumulative SVD burden can aid in risk stratification and management of ICH patients.
Background:
Individual cerebral small vessel disease (SVD) markers are independent predictors for poor prognosis following intracerebral hemorrhage (ICH), however, the impact of the cumulative SVD burden on outcomes remains unclear. We aimed to investigate the association between the global SVD burden and functional outcomes following ICH.
Methods:
We retrospectively evaluated a consecutive cohort of patients with ICH who underwent brain magnetic resonance imaging and magnetic resonance angiography, from a prospective registry. We identified the presence and severity of the SVD markers (cerebral microbleeds, lacunar infarctions, periventricular hyperintensities, and deep white matter hyperintensities) and summed them to obtain the modified total SVD score (0-4). Poor functional outcomes were defined as a modified Rankin Scale score at discharge ≥ 3. A multivariate logistic regression model was used to assess the association between patient outcomes and the SVD score.
Results:
A total of 144 patients were included (65.0 ± 12.2 years, 67.4% male). The modified total SVD score was potentially associated with poor functional outcomes (odds ratio [OR] 1.72, 95% confidence interval [CI] 0.97-3.03) after adjustment for age, sex, history of stroke, chronic kidney disease, prior use of antithrombotic agents, the National Institutes of Health Stroke Scale score on admission, the non-lobar location of ICH, and hematoma volume on admission. Moreover, among older patients (≥ 65 years), the SVD score was associated with poor outcomes (OR 3.11, 95% CI 1.01-9.55). Among those with supratentorial ICH, the score remained significant (OR 2.06, 95% CI 1.11-3.83).
Conclusions:
The modified total SVD score may have predictive value for poor functional outcomes following ICH.
