Risk Factors And Prognosis Of Cerebral Microbleeds In Hypertensive Intracerebral Hemorrhage Patients

Background and Objectives:Cerebral microbleeds(CMBs)were an intracerebral microangiopathy with bleeding tendency always found in intracerebral hemorrhage patients.Hypertensive intracerebral hemorrhage(HICH)took 70~80% of spontaneous intracerebral hemorrhage and CMBs incidence in ICH patients reached 50~80%.Nevertheless,the studies about CMBs effects on the prognosis of HICH patients were lacked.We performed a prospective study to discuss the risk factors of CMBs in HICH patients,and meanwhile,figure out the relationships between CMBs,silent brain infarction(SBI),intracerebral hemorrhage(ICH)and the prognosis.Methods:This study enrolled 100 patients diagnosed as HICH in 3 days after onset.MRI including susceptibility weighted imaging(SWI)and diffusion weighted imaging(DWI)were utilized to examine patients on the fifth day after onset.Regular follow-ups were carried out targeting on the following clinical cerebrovascular events or vascular related deaths in 1 year.Results:CMBs were observed in 55 subjects among those 100 HICH patients.Multiple logistic regression showed that old age,elevation of serum creatinine level and complicated leukoaraiosis were independently associated with CMBs.In addition,a higher SBI prevalence was also observed in patients with CMBs compared to those without CMBs(18.2% vs 2.2%,P=0.027).Despite of that,among the lobe hemorrhage patients,it was found that the hematoma volumes were more in patients with CMBs than in patients without.But the differences between CMBs positive and negative groups were reversed in the basal ganglia or thalamus hemorrhage patients.Compared with patients with no CMBs,CMBs ?5 was an independent risk factor in poor recovery of 3-month neurological function.During the 1-year follow-ups,14 subjects were attacked with clinical cerebrovascular events and vascular related deaths.The Cox proportional hazards model implicated that atrial fibrillation,CMBs ?5 and whether complicated with SBI were the independent predictive factors in clinical cerebrovascular accidents or deaths related with vascular events.Conclusion:Patients complicated with CMBs were more likely to have SBI.Poor recovery of 3-month neurological function were discovered in HICH patients with CMBs ?5.CMBs ?5 or SBI complication might indicate an elevation of risk about cerebrovascular events or vascular related deaths in 1 year.