Racial differences in microbleed prevalence in primary intracerebral hemorrhage

被引:49
作者
Copenhaver, B. R. [2 ]
Hsia, A. W. [1 ,2 ]
Merino, J. G. [3 ]
Burgess, R. E. [2 ]
Fifi, J. T. [1 ]
Davis, L. [4 ]
Warach, S. [4 ]
Kidwell, C. S. [1 ,2 ]
机构
[1] Washington Hosp Ctr, Stroke Ctr, Washington, DC 20010 USA
[2] Georgetown Univ, Dept Neurol, Washington, DC USA
[3] Suburban Hosp Stroke Program, Bethesda, MD USA
[4] NINDS, NIH, Bethesda, MD 20892 USA
关键词
D O I
10.1212/01.wnl.0000327524.16575.ca
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: Primary intracerebral hemorrhage is two to three times more common in many racial populations, including black patients. Previous studies have shown that microbleeds, identified on gradient echo MRI (GRE), are present in 50 - 80% of patients with primary ICH. The objective of this study was to compare, by race, the rates, risk factors, and topography of microbleeds in patients hospitalized for primary ICH. Methods: Patients diagnosed with primary ICH at two metropolitan stroke centers were included. Clinical and neuroimaging data were recorded for each patient. Analyses were performed to compare baseline characteristics as well as imaging findings by race. Results: A total of 87 patients met inclusion criteria ( 42 black subjects, 45 white subjects). The black cohort was younger (p < 0.001), and had a greater rate of hypertension (p < 0.001), but not other vascular risk factors. Microbleeds were more prevalent in the black population, with 74% of blacks having one or more microbleeds compared to 42% of whites (p < 0.005). The black population also tended to have a greater frequency of microbleeds in multiple territories than the white population (38% vs 22%, p = 0.106). When adjusting for age, hypertension, and alcohol use, race was an independent predictor of microbleeds (OR 3.308, 95% CI 1.144 - 9.571, p = 0.027). Conclusions: These pilot data suggest that significant racial differences exist in the frequency and topography of microbleeds in patients with primary ICH. Microbleeds may be an important emerging imaging biomarker with the potential to provide insights into ICH pathophysiology, prognosis, and disease progression, as well as possible therapeutic strategies, particularly in medically underserved populations.
引用
收藏
页码:1176 / 1182
页数:7
相关论文
共 24 条
[1]   Risk factors for intracerebral hemorrhage in the general population - A systematic review [J].
Ariesen, MJ ;
Claus, SP ;
Rinkel, GJE ;
Algra, A .
STROKE, 2003, 34 (08) :2060-2065
[2]   Spontaneous brain microbleeds: systematic review, subgroup analyses and standards for study design and reporting [J].
Cordonnier, Charlotte ;
Salman, Rustarn Ai-Shahi ;
Wardlaw, Joanna .
BRAIN, 2007, 130 :1988-2003
[3]  
Fazekas F, 1999, AM J NEURORADIOL, V20, P637
[4]   CT and MRI rating of white matter lesions [J].
Fazekas, F ;
Barkhof, F ;
Wahlund, LO ;
Pantoni, L ;
Erkinjuntti, T ;
Scheltens, P ;
Schmidt, R .
CEREBROVASCULAR DISEASES, 2002, 13 :31-36
[5]   Major risk factors for intracerebral hemorrhage in the young are modifiable [J].
Feldmann, E ;
Broderick, JP ;
Kernan, WN ;
Viscoli, CM ;
Brass, LM ;
Brott, T ;
Morgenstern, LB ;
Wilterdink, JL ;
Horwitz, RI .
STROKE, 2005, 36 (09) :1881-1885
[6]   Racial variations in location and risk of intracerebral hemorrhage [J].
Flaherty, ML ;
Woo, D ;
Haverbusch, M ;
Sekar, P ;
Khoury, J ;
Sauerbeck, L ;
Moomaw, CJ ;
Schneider, A ;
Kissela, B ;
Kleindorfer, D ;
Broderick, JP .
STROKE, 2005, 36 (05) :934-937
[7]   Hemorrhage burden predicts recurrent intracerebral hemorrhage after lobar hemorrhage [J].
Greenberg, SM ;
Eng, JA ;
Ning, MM ;
Smith, EE ;
Rosand, J .
STROKE, 2004, 35 (06) :1415-1420
[8]   MRI detection of new hemorrhages: Potential marker of progression in cerebral amyloid angiopathy [J].
Greenberg, SM ;
O'Donnell, HC ;
Schaefer, PW ;
Kraft, E .
NEUROLOGY, 1999, 53 (05) :1135-1138
[9]   Association of apolipoprotein E ε2 and vasculopathy in cerebral amyloid angiopathy [J].
Greenberg, SM ;
Vonsattel, JPG ;
Segal, AZ ;
Chiu, RI ;
Clatworthy, AE ;
Liao, A ;
Hyman, BT ;
Rebeck, GW .
NEUROLOGY, 1998, 50 (04) :961-965
[10]   Petechial hemorrhages accompanying lobar hemorrhage: Detection by gradient-echo MRI [J].
Greenberg, SM ;
Finklestein, SP ;
Schaefer, PW .
NEUROLOGY, 1996, 46 (06) :1751-1754