Association Between Tmax And Hypertensive Intracerebral Hemorrhage Outcomes Of Limb Motor Function

Objective:This paper explores the correlation between Tmax values in the 1-cm area around the hematoma and hypertensive cerebral hemorrhage outcomes of limb motor function.Methods:Data collection:In this paper,45 patients with hypertensive cerebral hemorrhage who met the inclusion criteria and were seen at the Second Affiliated Hospital of Zunyi Medical University between 2020-12-31 and 2022-01-31 were collected and general data（gender,age,etc.）,imaging data（CT,CTP,CTA）were recorded.CTP data included CBF,CBV,Tmax,and MTT values of the hematoma area of interest（area A）,the area within 1 cm of the hematoma（area B）,and the hemispheric specular area on the healthy side of area B（area B1）.CTA information included collateral circulation and vascular stenosis;FMS scores were recorded at bedside or by telephone at the time of admission and 3 months after bleeding.FMS>95 at 3 months after bleeding was considered good outcomes,and FMS≤95 was considered poor outcomes.Data processing:Patients were divided into good outcomes and poor outcomes groups according to their FMS scores at 3 months after bleeding,and this paper used t-test or u-test and chi-square test for comparison between groups.It used univariate,binary logistic regression to analyze the effects of Tmax and other parameters on the outcomes of limb motor function3 months after hypertensive cerebral hemorrhage.Correlation analysis of Tmax with FMS score and collateral circulation was performed using Spearman test.It uses ROC curves to analyze whether Tmax predicts hypertensive cerebral hemorrhage outcomes of limb motor function and to derive the optimal threshold value.Results:A total of 45 patients with hypertensive cerebral hemorrhage with a hemorrhage volume of 16.92（7.46-25.74）cm³were included,and 82.22%of patients had a hemorrhage volume<30 cm3.The Tmax（B）values in the area within 1 cm of the affected hemisphere hematoma were significantly lower compared to the healthy side of the microscopic area.Compared with the good outcomes group,the poor outcomes group had higher Tmax（B）,admission NIHSS,bleeding volume,and worse collateral circulation,with statistically significant differences（P<0.05）.Univariate logistic regression analysis revealed that Tmax（B）,admission NIHSS,bleeding volume,and collateral circulation had an effect on the outcomes of limb motor function 3 months after hypertensive cerebral hemorrhage（P<0.05）.After binary logistic regression analysis adjusted for variables with P<0.1 in the univariate analysis,only Tmax（B）was an independent variable for poor outcomes of limb motor function 3 months after hypertensive cerebral hemorrhage of limb motor function was an independent risk factor for poor outcomes[OR=2.57,95%CI（1.17-5.66）,P=0.018].Tmax（B）was negatively correlated with FMS score 3 months after hypertensive cerebral hemorrhage（r=-0.652,P<0.001）,and it predicted outcomes of limb motor function 3 months after hypertensive cerebral hemorrhage function(AUC_Tmax（B）=0.839,P<0.001).The best critical value was>4.12s（sensitivity 90.48%,specificity79.17%）;Tmax（B）>4s was positively correlated with moderate strength of collateral circulation difference（r=0.512,P<0.001）.Conclusion:Elevated Tmax in the area within 1 cm of the hematoma is associated with worse outcomes of limb motor function.Impaired collateral circulation may contribute to the poor outcomes of limb motor function due to elevated Tmax.By improving perfusion in the area around the hematoma after hypertensive cerebral hemorrhage may be able to improve the patient’s outcomes of limb motor function.