Abstract
There have been many reports about the prognosis and risk factors of stroke recurrence following brain infarction (BI). However, little is known about the stroke recurrence after primary intracerebral hemorrhage (PICH). Therefore, we explored the recurrent stroke patients after initial PICH retrospectively, to reveal the critical factors of stroke recurrence. Acute BI (n=4013) and acute PICH patients (n=1067) admitted to the hospital between April 2000 and March 2009 were consecutively screened. PICH patients with a history of ICH and BI patients with a history of ICH were then classified into the ICH-ICH group (n=64, age 70.8±9.5 years) and ICH-BI group (n=52, age 72.8±9.7years), respectively. ICH lesions were categorized into ganglionic and lober types according to the brain magnetic resonance imaging. Subtypes of BI were classified into cardioembolism, large-artery atherosclerosis, small-artery occlusion and others. There was no difference in incidence of risk factors between ICH-ICH and ICH-BI groups. Distribution of initial PICH lesions was significantly abundant in the lobar type in the ICH-ICH group (P<0.01) and in ganglionic type in the ICH-BI group (P<0.02). Age of onset was significantly older in recurrent lobar ICH compared with recurrent ganglionic ICH (P<0.01: 73.6±10.0 and 59.1±9.0 years, respectively). In conclusion, ganglionic ICH patients may have a chance of recurrent stroke in both brain infarction and ganglionic ICH, suggesting the participation of atherosclerosis in intracranial arteries. Lobar ICH patients were older and prone to recurrent lobar ICH, suggesting the participation of cerebral amyloid angiopathy as a risk of stroke recurrence.
Highlights
Risk at recurrent stroke (%) HypertensionIn Japan, primary intracerebral hemorrhage (PICH) accounts for about 20% of all strokes Diabetes mellitus Hyperlipidaemia (14.1) (13.5)0.999 and has a mortality rate of 16%, which is about Atrial fibrillation0.999 three times higher than that of brain infarc- ICH, intracerebral hemorrhage; BI, brain infarction; SD, standard deviation. [page 40][Neurology International 2012; 4:e10]Article were confirmed by brain magnetic resonance the thalamus was significantly higher in the in thalamus or putamen showed a similar disimaging, using T2 (TR: 4000sec, TE: 92sec) ICH-BI group than the ICH-ICH group tribution in the lesions of recurrent stroke, i.e.and T2* weighted images (TR: 3100sec, TE: (P=0.021: 40.4% and 31.3%, respectively).the most frequent type was thalamic ICH28sec)
To identify the effective treatments carried out the screening of patients’ data and prognosis and risk factors of stroke recur- for preventing recurrent strokes, we explored assessed all lesions which were observed on the rence following brain infarction (BI). the difference in clinical features between MRI; MS, performed the data analysis and little is known about the stroke recurrence after primary intracerebral hemly orrhage (PICH)
Acute stroke patients who were admitted to the hospital within 24 h after onset were enrolled in this study (PICH: n=1067 and BI: n=4013)
Summary
We explored the recurrent stroke patients after initial PICH Distribution of o initial PICH lesions was significantly abun-c dant in the lobar type in the ICH-ICH group (P
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