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Long-term outcome of cerebral amyloid angiopathy-related hemorrhage

Ruiwen Che1,2, Mengke Zhang1, Hailiang Sun3

  • 1Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.

CNS Neuroscience & Therapeutics
|August 17, 2022
PubMed

Insights

Nearly half of cerebral amyloid angiopathy-related hemorrhage (CAAH) patients achieve good long-term outcomes. Glasgow Coma Scale score, recurrent intracerebral hemorrhage, white matter lesion grade, and cerebral atrophy predict outcomes.

Area of Science:

  • Neurology
  • Neurosurgery
  • Geriatric Medicine

Background:

  • Cerebral amyloid angiopathy-related hemorrhage (CAAH) is a significant cause of spontaneous intracerebral hemorrhage, particularly in the elderly.
  • Long-term functional outcomes and prognostic factors for CAAH patients remain incompletely understood.
  • Understanding these factors is crucial for patient management and prognosis prediction.

Purpose of the Study:

  • To assess the long-term functional outcomes of patients with cerebral amyloid angiopathy-related hemorrhage (CAAH).
  • To identify independent prognostic factors associated with unfavorable long-term outcomes in CAAH patients.

Main Methods:

  • An observational study including consecutive CAAH patients from 2014 to 2020.
  • Collection of baseline characteristics and clinical outcomes.
  • Multivariable logistic regression analysis to identify prognostic factors for long-term outcomes.

Main Results:

  • Out of 141 CAAH patients, 50.4% achieved favorable long-term outcomes, with a 23.4% mortality rate at a median follow-up of 19 months.
  • Independent predictors for unfavorable long-term outcomes included lower Glasgow Coma Scale (GCS) on admission, recurrence of intracerebral hemorrhage (ICH), high white matter lesion (WML) grade (3-4), and severe central cerebral atrophy.
  • Statistical significance was observed for GCS (p=0.008), ICH recurrence (p=0.011), WML grade (p=0.047), and cerebral atrophy (p=0.008).

Conclusions:

  • Approximately 50% of CAAH patients experience favorable long-term functional outcomes.
  • Glasgow Coma Scale score, intracerebral hemorrhage recurrence, white matter lesion grade, and cerebral atrophy are significant independent prognostic factors for long-term outcomes in CAAH patients.
  • These identified factors can aid in predicting prognosis and guiding clinical management strategies for CAAH.
Abstract

Keywords:
cerebral amyloid angiopathycerebral small vessel diseasesintracranial hemorrhagesneuroimagingsurvival analysistreatment outcome

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