The Relationship Between Cerebral Microbleeds And Stroke Recurrence In Intracerebral Hemorrhage Patients

Objective: This study attempts to explore the significance and value of cerebral microbleeds(CMBs)in predicting the risk of stroke recurrence and death after intracerebral hemorrhage,and in order to help clinicians to develop scientific secondary prevention strategies for patients who survive after intracerebral hemorrhage.Methods: A total of 186 patients with primary acute intracerebral hemorrhage were consecutively enrolled,who admitted to the Department of Neurology,Yan’an University Affiliated Xianyang Hospital from 2020.01.01 to 2022.02.28.All patients received standard diagnosis and treatment according to Chinese guidelines for diagnosis and treatment of acute intracerebral hemorrhage 2019.Susceptibility Weighted Imaging(SWI)was used to detect CMBs.Patients were divided into CMBs group and non-CMBs group according to the presence of CMBs.according to the burden is divided into 0,1-4,5-10,11-19,≥20 five groups;According to the anatomical distribution of CMBs,they were divided into cerebral Lobe group,Deep group,Subtentorial group and the Mixed group.Telephone follow-up was conducted every 90 days after discharge and the follow-up period was 12 months,the end points were stroke recurrence(both ischemic and hemorrhagic)and all-cause death.The follow-up deadline is 2023.2.28.This study used a composite endpoint,which included recurrent stroke(ischemic and hemorrhagic)and all-cause death.Cox regression model was used to evaluate the influence of the presence,burden and distribution of CMBs on the risk of recurrent stroke and death in patients who survived intracerebral hemorrhage.Results: A total of 186 patients with intracerebral hemorrhage were included in this study,15 patients were lost to follow-up,and 171 patients were finally included into statistical analysis.There were 121 patients in CMBs group and 50 in non-CMBs group.The detection rate of CMBs was about 70.8%.Multiple Logistic regression analysis showed that age(p<0.001)and hypertension(p = 0.001)were risk factors of cerebral microbleeds.During the follow-up,16 patients(9.4%)had happened endpoint events,including 5 patients(2.9%)with ischemic stroke,5 patients(2.9%)with recurrent intracerebral hemorrhage,and 6 patients(3.5%)with all-cause death.Multivariate Cox regression analysis showed that previous history of cerebral infarction(RR=3.160,95%CI: 1.148-8.698,p =0.026)was an independent risk factor for composite endpoints such as stroke recurrence or death in patients with intracerebral hemorrhage,but no significant differences were found in the presence,burden and distribution of CMBs.Conclusion: CMBs has a high prevalence in patients with cerebral hemorrhage.Age and hypertension are risk factors for the occurrence of cerebral microbleeds in patients with intracerebral hemorrhage.There is no significant difference between the presence,burden and site distribution of CMBs and the risk of stroke recurrence and death in patients with intracerebral hemorrhage.Previous history of cerebral infarction is an independent risk factor for composite endpoints such as stroke recurrence or death in patients with intracerebral hemorrhage.The risk of composite endpoints was approximately threefold higher in patients with prior cerebral infarction in 1 year.