Open Access
01-02-2025 | Intracerebral Hemorrhage | Original Communication
Subarachnoid hemorrhage and finger-like projection predict recurrence in patients with lobar intracerebral hemorrhage
Authors:
Xin Huang, Xiangzhu Zeng, Lu Tang, Xiaolu Liu, Xiao Huang, Xiangyi Liu, Zhuoya Wang, Nan Li, Dongsheng Fan, Qiong Yang
Published in:
Journal of Neurology
|
Issue 2/2025
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Abstract
Background and purpose
Lobar intracerebral hemorrhage (ICH) is associated with a high risk of recurrence, particularly in elderly patients, where cerebral amyloid angiopathy (CAA) is often the primary cause. Diagnostic markers of CAA-related ICH, including subarachnoid hemorrhage (SAH) and finger-like projection (FLP), have recently been developed. Here, we aimed to explore the associations between SAH, FLP and the risk of ICH recurrence in lobar ICH patients.
Methods
We analyzed data from consecutive lobar ICH patients using the method of cohort study. We divided them into 4 groups on the basis of the presence or absence of SAH and FLP on CT imaging. The Cox regression model and competing risk model were used to analyze the associations of SAH and FLP with the risk of ICH recurrence at 1 year.
Results
In total, 353 patients with lobar ICH (median age 74 [62, 81] years, 57.2% male) were included in our study. During follow-up, recurrence occurred in 34 patients (10.6%), and 90 patients (28.1%) died. The competing risk model revealed that patients in the SAH + FLP- (HR 2.88, 95% CI 1.12–7.44, p = 0.03) and SAH + FLP + (HR 8.38, 95% CI 3.40–20.66, p < 0.001) groups had higher risks of ICH recurrence within 1 year than did those in the SAH-FLP- group.
Conclusion
SAH is an important predictor of ICH recurrence, and this predictive ability is further enhanced when FLP is present. These findings suggest that SAH, especially with FLP, can be a valuable tool for assessing prognosis in lobar ICH patients.