Influence of Intracerebral Hemorrhage Location on Incidence, Characteristics, and Outcome
Author:
Samarasekera Neshika1, Fonville Arthur1, Lerpiniere Christine1, Farrall Andrew J.1, Wardlaw Joanna M.1, White Philip M.1, Smith Colin1, Al-Shahi Salman Rustam1, Addison Anne2, Ahmad Kate2, Alhadad Syed2, Andrews Peter2, Bisset Elaine2, Bodkin Peter2, Bouhaidar Ralph2, Brennan Paul2, Campbell Brian2, Chandran Siddharthan2, Cook Helen2, Davenport Richard2, Dennis Martin2, Derry Chris2, Dodds Katrina2, Doubal Fergus2, Duncan Susan2, Elder Andrew2, Fitzpatrick Mike2, Foley Peter2, Fouyas Ioannis2, Ghosh Sudipto2, Gibson Rod2, Gordon Claire2, Grant Robin2, Hewett Russell2, Hughes Fiona2, Hughes Mark2, Hunt David2, Hunter Neil2, Ironside James2, Liaquat Imran2, Josephson Colin2, Kamat Anant2, Kealley Susan2, Keir Sarah2, Kerr Gillian2, Kerrigan Simon2, Keston Peter2, King Matthew2, Knight Richard2, Macdonald Elizabeth2, Mackay Graham2, Macleod Donald2, Macleod Malcolm2, Maguire Conor2, Makin Steven2, Mathews Ashok2, Maxwell Fiona2, McClellan Stuart2, Millar Tracey2, Morris Zoe2, Morse Tim2, Mumford Colin2, Murray Katherine2, Myles Lynn2, Nimmo Graham2, Ng Yi2, Pal Suvankar2, Rannikmae Kristiina2, Rhodes Jonathan2, Ross Jerard2, Russell Tim2, Sandercock Peter2, Sellar Robin2, Shanmuganathan Mano2, Shekhar Himanshu2, Simms Henry2, Sittampalam Mara2, Soleiman Hamza2, Spiers Helen2, Statham Patrick2, Stavrinos Neo2, Stone Jon2, Stuart Joyce2, Sudlow Cathie2, Summers David2, Taylor Pat2, Torgersen Antonia2, van Dijke Margarethe2, Walker Robert2, Weller Belinda2, Whiteley William2, Whittle Ian2, Will Robert2, Young Wendy2, Anderson Judith3, Broadbent Seona3, Butler Laura3, Caesar Dave3, Cantley Patricia3, Carter Jonathan3, Clegg Gareth3, Coull Andrew3, Crosswaite Alastair3, Dear James3, Dummer Simon3, Duncan Fiona3, Elder-Gracie Trish3, Enright Kate3, Fitzgerald Tom3, Fothergill Jane3, Frier Brian3, Grant David3, Gray Alasdair3, Hart Simon3, Henderson Robin3, Jaap Alan3, Leigh-Smith Simon3, Jones Michael3, Masson Moyra3, McCallum Lynn3, McKechnie Martin3, McKillop Graham3, Mead Gillian3, Morley Wendy3, Morrow Billie3, Morrow Frank3, Murchison Jon3, Murphy Ross3, Ng Jasmine3, Ogundipe Olayinka3, Patel Dilip3, Pollock Alison3, Reed Matthew3, Roberts Geraint3, Selvarajah Johann3, Smith Randy3, Stirling Claire3, Turner Neil3, Wilson Matthew3, Yordanov Stanko3, Bell Nicola4, Chambers Sarah4, Dewar Sandra4, Farquhar Donald4, Harmouche Ali4, Jacob Ashok4, Jackson Katherine4, Knox Anne4, McCafferty Jon4, Moultrie Sam4, Munang Latana4, Noble Donald4, Ramsay Scott4, Spence Linda4, Threlfall Bethany4, Williams Adrian4, Wilson James4, Fitzgerald Alastair5, Jamieson Andrew5, Lange Peter5, McIntosh Andrew5, Morrison Lewis5, Todd Iain5
Affiliation:
1. From the Division of Clinical Neurosciences, Centre for Clinical Brain Sciences (N.S., A.F., C.L., A.J.F., J.M.W., C.S., R.A.-S.S.), Brain Research Imaging Centre (A.J.F., J.M.W.), and Centre for Cognitive Ageing and Cognitive Epidemiology (J.M.W.), University of Edinburgh, Edinburgh, United Kingdom; and Newcastle University Institute for Ageing and Health, Newcastle upon Tyne, United Kingdom (P.M.W.). 2. Western General Hospital, Edinburgh 3. Royal Infirmary of Edinburgh 4. St John’s Hospital, West Lothian 5. Astley Ainslie and Liberton Hospitals, Edinburgh
Abstract
Background and Purpose—
The characteristics of intracerebral hemorrhage (ICH) may vary by ICH location because of differences in the distribution of underlying cerebral small vessel diseases. Therefore, we investigated the incidence, characteristics, and outcome of lobar and nonlobar ICH.
Methods—
In a population-based, prospective inception cohort study of ICH, we used multiple overlapping sources of case ascertainment and follow-up to identify and validate ICH diagnoses in 2010 to 2011 in an adult population of 695 335.
Results—
There were 128 participants with first-ever primary ICH. The overall incidence of lobar ICH was similar to nonlobar ICH (9.8 [95% confidence interval, 7.7–12.4] versus 8.6 [95% confidence interval, 6.7–11.1] per 100 000 adults/y). At baseline, adults with lobar ICH were more likely to have preceding dementia (21% versus 5%;
P
=0.01), lower Glasgow Coma Scale scores (median, 13 versus 14;
P
=0.03), larger ICHs (median, 38 versus 11 mL;
P
<0.001), subarachnoid extension (57% versus 5%;
P
<0.001), and subdural extension (15% versus 3%;
P
=0.02) than those with nonlobar ICH. One-year case fatality was lower after lobar ICH than after nonlobar ICH (adjusted odds ratio for death at 1 year: lobar versus nonlobar ICH 0.21; 95% confidence interval, 0.07–0.63;
P
=0.006, after adjustment for known predictors of outcome). There were 4 recurrent ICHs, which occurred exclusively in survivors of lobar ICH (annual risk of recurrent ICH after lobar ICH, 11.8%; 95% confidence interval, 4.6%–28.5% versus 0% after nonlobar ICH; log-rank
P
=0.04).
Conclusions—
The baseline characteristics and outcome of lobar ICH differ from other locations.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Advanced and Specialized Nursing,Cardiology and Cardiovascular Medicine,Neurology (clinical)
Reference85 articles.
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