The Risk Factors Of Cerebral Microbleeds And Its Correlation To Prognosis In Primary Intracerebral Hemorrhage

Background and objective:Current studies about cerebral microbleeds(CMBs)on the prognosis of stroke were mainly concentrated on ischemic stroke,with limited information regard to hemorrhagic stroke.Our study aims to explore the associated factors of CMBs and its correlation with prognosis in primary intracerebral hemorrhage(ICH).Methods:Two hundred and nighty-seven primary ICH patients eligible for our study were enrolled,of whom the time from symptom onset within 72 hours.The demographic and clinical characteristics,laboratory parameters and imaging data were recorded in detail.The 90-day follow up was regularly performed and the mRS was evaluated.Patients were divided into 2 groups according to the presence of CMBs in images.By using the univariate and multivariate logistic analysis,we try to illustrate the associated factors of CMBs and its correlation with prognosis in ICH patients.All statistical analyses were performed using IBM SPSS Statistics version 22.0.Results:Of all,a total of 1795 CMBs were observed in 201 patients(67.7%).Among these lesions,the cortical and subcortical areas were the predominant locations with a proportion of 50.6%,followed by deep structure,cerebellum and brainstem with a proportion of 33.3%,9.4%and 6.7%,respectively.The patients were classified as mild(1-5),moderate(6-15)and severe(>15),according to the number of CMBs.In univariate analysis,we found that the ICH patients with or without CMBs had statistic differences in age,the history of hypertension,ICH and cerebral infarction/transient ischemic attack,low-density lipoprotein cholesterin,and fasting blood glucose.In logistic modeling,age and the history of hypertension and ICH were independent factors related to CMBs in ICH,and moderate-severe CMBs(>5)were associated with 90-day poor prognosis of ICH patients.We further compared other imaging markers of cerebral small vessel disease(CSVD)such as white matter lesion(WML),lacunar infarction(LI)between two groups.We discovered that WMH and LI were more prevalent in patients with CMBs,implying that ICH patients with CMBs may have more severe CSVD.Conclusions:Age and the histories of hypertension and ICH were independent risk factors related to CMBs in ICH.WML and LI were more prevalent in patients with CMBs.CMBs>5 were independently associated with 90-day poor prognosis of ICH patients.