Abstract TP346: Quantitative Analysis of Intracranial Blood Volumes and Relationship With Stress Induced Hyperglycemia and Outcomes in Intracerebral Hemorrhage

Abstract

Introduction: Stress-induced hyperglycemia (SIH) is independently associated with poor clinical outcome in intracerebral hemorrhage (ICH). It is unknown if quantitative radiological parameters determine SIH in ICH population. Hypothesis: Investigate whether SIH is associated with change in intracranial volume due to ICH using unbiased quantitative estimation, intraventricular hemorrhage (IVH) and ICH location. Methods: Retrospective cohort of 328 patients with spontaneous ICH over 5-year. Glycemic Gap (GG) is used to define SIH. Receiver Operator Curve (ROC) determined threshold for adverse outcomes (hospice or death). Blood volume was estimated in each intracranial compartment on admission head Computed Tomography (CT) using image segmentation software. Linear regression models and Pearson’s correlation analysis were used to study inter-relationship between SIH, ICH and IVH volume. Results: A GG of 29.5 mg/dL and higher defined SIH in this study cohort. Patients with SIH had significantly larger hemorrhage (30.5 mL vs 17.6 mL, p<0.005). ICH, IVH volumes and SIH showed positive correlation (r=0.185, p<0.005; r=0.233, p<0.005 respectively). Subcortically located ICH patients were more likely to have SIH as compared to other locations (ANOVA F-test p-value 0.011). ICH score also showed positive correlation with SIH (r =0.333, p<0.005). For each point increase in ICH score, GG increased by 10.6 mg/dL. Conclusion: Our single center retrospective study reports dose dependent SIH with ICH/IVH volumes and subcortical hemorrhage location. Such observation likely alludes to involvement of hypothalamo-pituitary endocrine axis in pathogenesis of SIH after ICH.