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Significance of Cerebral Small-Vessel Disease in Acute Intracerebral Hemorrhage

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dc.contributor.author Sato, Shoichiro
dc.contributor.author Delcourt, Candice
dc.contributor.author Heeley, Emma
dc.contributor.author Arima, Hisatomi
dc.contributor.author Zhang, Shihong
dc.contributor.author Salman, Rustam
dc.contributor.author Stapf, Christian
dc.contributor.author Woo, Daniel
dc.contributor.author Flaherty, Matthew
dc.contributor.author Vagal, Achala
dc.contributor.author Levi, Christopher
dc.contributor.author Davies, Leo
dc.contributor.author Wang, Jiguang
dc.contributor.author Thompson, Robinson
dc.contributor.author Lavados, Pablo
dc.contributor.author Lindley, Richard
dc.contributor.author Chalmers, John
dc.contributor.author Anderson, Craig
dc.contributor.author INTERACT2 Investigators
dc.date.accessioned 2017-01-06T12:27:50Z
dc.date.available 2017-01-06T12:27:50Z
dc.date.issued 2016
dc.identifier.citation Stroke, March 2016, vol.47,n°3,p.701-707 es_CL
dc.identifier.uri http://dx.doi.org/10.1161/STROKEAHA.115.012147 es_CL
dc.identifier.uri http://hdl.handle.net/11447/932
dc.description.abstract BACKGROUND AND PURPOSE: The significance of structural changes associated with cerebral small-vessel disease (SVD), including white matter lesions (WML), lacunes, and brain atrophy, to outcome from acute intracerebral hemorrhage is uncertain. We determined associations of computed tomographic radiological manifestations of cerebral SVD and outcomes, and in terms of any differential effect of early intensive blood pressure-lowering treatment, in the large-scale Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial (INTERACT2). METHODS: We graded WML (van Swieten scale), the presence of lacunes, and brain atrophy (2 linear measurements and visual rating) for 2069 of 2839 patients with available baseline brain computed tomography (<6 hours of intracerebral hemorrhage onset) by 3 independent neurologists blind to clinical data. RESULTS: WML grade and 2 linear measurements of brain atrophy were associated with death or major disability at 90 days: multivariable-adjusted odds ratios for WML (grade 3 and 4 versus 0), frontal ratio, and third ventricle Sylvian fissure distance (most versus least severe atrophy quartile) were 1.42 (95% confidence interval, 1.02-1.98), 1.47 (1.08-1.99), and 1.64 (1.21-2.22), respectively (all P for trend <0.05). There was no association between lacunes and outcomes. There were no significant differences in the effects of intensive blood pressure-lowering across subgroups of cerebral SVD. CONCLUSIONS: Preexisting cerebral SVD manifestations of WML and brain atrophy predict poor outcome in acute intracerebral hemorrhage. There is no apparent hazard of early intensive lowering of blood pressure according to the INTERACT2 protocol, in patients with underlying cerebral SVD. es_CL
dc.language.iso en_US es_CL
dc.publisher American Heart Association, Inc. es_CL
dc.subject Bblood pressure es_CL
dc.subject Cerebral hemorrhage es_CL
dc.subject Cerebral small vessel disease es_CL
dc.subject Hypertension es_CL
dc.subject Stroke es_CL
dc.title Significance of Cerebral Small-Vessel Disease in Acute Intracerebral Hemorrhage es_CL
dc.type Artículo es_CL


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