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The relation between acute intracerebral hemorrhage and diffusion-weighted imaging lesions: a meta-analysis

Journal of thrombosis and thrombolysis, 2021-10, Vol.52 (3), p.962-970 [Peer Reviewed Journal]

The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021 ;2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. ;The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021. ;ISSN: 0929-5305 ;EISSN: 1573-742X ;DOI: 10.1007/s11239-021-02430-6 ;PMID: 33783661

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  • Title:
    The relation between acute intracerebral hemorrhage and diffusion-weighted imaging lesions: a meta-analysis
  • Author: Li, Xiang ; Zhang, Bei ; Lou, Mingwu
  • Subjects: Blood Pressure ; Cardiology ; Cerebral Hemorrhage - diagnostic imaging ; Cognitive ability ; Diabetes mellitus ; Diffusion Magnetic Resonance Imaging ; Hematology ; Hemorrhage ; Humans ; Hypercholesterolemia ; Hypertension ; Ischemia ; Lesions ; Medicine ; Medicine & Public Health ; Meta-analysis ; Risk factors ; Stroke
  • Is Part Of: Journal of thrombosis and thrombolysis, 2021-10, Vol.52 (3), p.962-970
  • Description: Diffusion-weighted imaging lesions in intracerebral hemorrhage are related to a higher risk of recurrent intracerebral hemorrhage, cognitive damage, and mortality. However, it has been reported that the relationship between the risk of diffusion-weighted imaging lesions and intracerebral hemorrhage subtype or the possible risk factors for diffusion-weighted imaging lesions is variable. This meta-analysis was performed to evaluate this relationship. A systematic literature search up-to August 2020 was performed and 12 studies included 2815 subjects at the baseline with intracerebral hemorrhage. Odds ratio (OR) or mean difference (MD) with 95% confidence intervals (CIs) was calculated to evaluate the prognostic role of diffusion-weighted imaging lesions and intracerebral hemorrhage subtype and investigated the possible risk factors for diffusion-weighted imaging lesions using the dichotomous and continuous methods with a random or fixed-effect model. Lobar intracerebral hemorrhage was not significantly related to a higher rate of diffusion-weighted imaging lesions (OR, 1.01; 95% CI, 0.75–1.36, p = 0.94) compared to the non-lobar intracerebral hemorrhage. Also, history of diabetes mellitus (OR, 1.15; 95% CI, 0.83–1.60, p = 0.39); history of smoking (OR, 0.95; 95% CI, 0.68–1.33, p = 0.76); history of hypercholesterolemia (OR, 1.04; 95% CI, 0.73–1.48, p = 0.83); and history of ischemic stroke (OR, 1.63; 95% CI, 0.57–4.66, p = 0.36) were not significantly related to higher rate of diffusion-weighted imaging lesions compared to no history of those factors. However, the history of hypertension was significantly related to a higher rate of diffusion-weighted imaging lesions (OR, 1.33; 95% CI, 1.04–1.70, p = 0.02) compared to no history of hypertension. Also, Subjects with diffusion-weighted imaging lesions had a greater decrease in systolic pressure in the acute phase of the intracerebral hemorrhage (MD, 10.23; 95% CI, 7.41–13.06, p < 0.001) compared to without diffusion-weighted imaging lesions. Based on this meta-analysis, the history of hypertension may have an independent risk relationship with a higher rate of diffusion-weighted imaging lesions. Also, subjects with diffusion-weighted imaging lesions had a greater decrease in systolic pressure in the acute phase of the intracerebral hemorrhage compared to those without diffusion-weighted imaging lesions. This relationship forces us to recommend that identification of diffusion-weighted imaging lesions might add appreciated evidence to evaluate the progression of the underlying micro-angiopathy especially in subjects with a history of hypertension. Though further studies are needed to define the mechanisms by which these lesions may lead to cognitive damage and stroke reappearance.
  • Publisher: New York: Springer US
  • Language: English
  • Identifier: ISSN: 0929-5305
    EISSN: 1573-742X
    DOI: 10.1007/s11239-021-02430-6
    PMID: 33783661
  • Source: AUTh Library subscriptions: ProQuest Central
    MEDLINE
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