Medial intracranial carotid artery calcifications and hematoma expansion in deep intracerebral hemorrhage
Abstract Background Medial intracranial carotid artery calcifications (ICAC) are associated with impaired vascular physiology, increased arterial stiffness and pulse pressure. Their presence might therefore be associated with increased risk of intracerebral hemorrhage (ICH) expansion, according to t...
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Wiley
2024-12-01
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| Series: | Annals of Clinical and Translational Neurology |
| Online Access: | https://doi.org/10.1002/acn3.52240 |
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| author | Federico Mazzacane Stefan Moraru Beatrice Del Bello Federica Ferrari Erica Ferro Alessandra Persico Jawed Nawabi Alessandro Padovani Anna Cavallini Andrea Morotti |
| author_facet | Federico Mazzacane Stefan Moraru Beatrice Del Bello Federica Ferrari Erica Ferro Alessandra Persico Jawed Nawabi Alessandro Padovani Anna Cavallini Andrea Morotti |
| author_sort | Federico Mazzacane |
| collection | DOAJ |
| description | Abstract Background Medial intracranial carotid artery calcifications (ICAC) are associated with impaired vascular physiology, increased arterial stiffness and pulse pressure. Their presence might therefore be associated with increased risk of intracerebral hemorrhage (ICH) expansion, according to the avalanche model. We explored the association between ICAC presence and pattern and hematoma expansion (HE). Methods Retrospective analysis of a monocentric, prospectively collected cohort of ICH patients admitted between June 2017 and October 2023. ICAC pattern was determined by Kockelkoren's rating scale on admission CT; medial ICAC were defined with a >6 points cutoff. A follow‐up CT scan was performed within 72 h. HE was analyzed as a dichotomous (≥6 mL and/or ≥33%) and as a categorical (none/mild/moderate/severe) variable, and its predictors were explored with logistic and ordinal regression respectively, accounting for baseline volume, onset‐to‐CT time, and anticoagulation. All the analyses were stratified by ICH location (supratentorial deep vs lobar ICH). Results A total of 201 patients were included (median age 78, 42% females, 59% deep ICH). Medial ICAC were significantly more common in deep ICH with HE compared with non‐expanders (72% vs 49%, p = 0.03), whereas there was no association between ICAC and HE in lobar ICH (53% vs 52%, p = 0.85). This association between medial ICAC and HE in deep ICH remained significant in logistic (aOR 3.11, 95% CI [1.19–9.06], p = 0.03) and ordinal regression (acOR 2.42, 95% CI [1.19–4.99], p = 0.01). Interpretation Ipsilateral medial ICAC are associated with higher odds of HE in deep ICH. Our findings are best interpreted as hypothesis generating, requiring prospective validation and further research to characterize the underlying biological mechanisms. |
| format | Article |
| id | doaj-art-54f5ab86d00a4502b3a7d31cb7754e19 |
| institution | OA Journals |
| issn | 2328-9503 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Clinical and Translational Neurology |
| spelling | doaj-art-54f5ab86d00a4502b3a7d31cb7754e192025-08-20T01:58:23ZengWileyAnnals of Clinical and Translational Neurology2328-95032024-12-0111123246325410.1002/acn3.52240Medial intracranial carotid artery calcifications and hematoma expansion in deep intracerebral hemorrhageFederico Mazzacane0Stefan Moraru1Beatrice Del Bello2Federica Ferrari3Erica Ferro4Alessandra Persico5Jawed Nawabi6Alessandro Padovani7Anna Cavallini8Andrea Morotti9Department of Brain and Behavioral Sciences University of Pavia Pavia ItalyDepartment of Brain and Behavioral Sciences University of Pavia Pavia ItalyDepartment of Brain and Behavioral Sciences University of Pavia Pavia ItalyDepartment of Brain and Behavioral Sciences University of Pavia Pavia ItalyDepartment of Brain and Behavioral Sciences University of Pavia Pavia ItalyDepartment of Stroke Unit and Emergency Neurology IRCCS Mondino Foundation Pavia ItalyDepartment of Neuroradiology Charité – Universitätsmedizin Berlin, Campus Mitte, Humboldt‐Universität zu Berlin, Freie Universität Berlin, Berlin Institute of Health Berlin GermanyDepartment of Continuity of Care and Frailty, Neurology Unit ASST‐Spedali Civili Brescia ItalyDepartment of Stroke Unit and Emergency Neurology IRCCS Mondino Foundation Pavia ItalyDepartment of Continuity of Care and Frailty, Neurology Unit ASST‐Spedali Civili Brescia ItalyAbstract Background Medial intracranial carotid artery calcifications (ICAC) are associated with impaired vascular physiology, increased arterial stiffness and pulse pressure. Their presence might therefore be associated with increased risk of intracerebral hemorrhage (ICH) expansion, according to the avalanche model. We explored the association between ICAC presence and pattern and hematoma expansion (HE). Methods Retrospective analysis of a monocentric, prospectively collected cohort of ICH patients admitted between June 2017 and October 2023. ICAC pattern was determined by Kockelkoren's rating scale on admission CT; medial ICAC were defined with a >6 points cutoff. A follow‐up CT scan was performed within 72 h. HE was analyzed as a dichotomous (≥6 mL and/or ≥33%) and as a categorical (none/mild/moderate/severe) variable, and its predictors were explored with logistic and ordinal regression respectively, accounting for baseline volume, onset‐to‐CT time, and anticoagulation. All the analyses were stratified by ICH location (supratentorial deep vs lobar ICH). Results A total of 201 patients were included (median age 78, 42% females, 59% deep ICH). Medial ICAC were significantly more common in deep ICH with HE compared with non‐expanders (72% vs 49%, p = 0.03), whereas there was no association between ICAC and HE in lobar ICH (53% vs 52%, p = 0.85). This association between medial ICAC and HE in deep ICH remained significant in logistic (aOR 3.11, 95% CI [1.19–9.06], p = 0.03) and ordinal regression (acOR 2.42, 95% CI [1.19–4.99], p = 0.01). Interpretation Ipsilateral medial ICAC are associated with higher odds of HE in deep ICH. Our findings are best interpreted as hypothesis generating, requiring prospective validation and further research to characterize the underlying biological mechanisms.https://doi.org/10.1002/acn3.52240 |
| spellingShingle | Federico Mazzacane Stefan Moraru Beatrice Del Bello Federica Ferrari Erica Ferro Alessandra Persico Jawed Nawabi Alessandro Padovani Anna Cavallini Andrea Morotti Medial intracranial carotid artery calcifications and hematoma expansion in deep intracerebral hemorrhage Annals of Clinical and Translational Neurology |
| title | Medial intracranial carotid artery calcifications and hematoma expansion in deep intracerebral hemorrhage |
| title_full | Medial intracranial carotid artery calcifications and hematoma expansion in deep intracerebral hemorrhage |
| title_fullStr | Medial intracranial carotid artery calcifications and hematoma expansion in deep intracerebral hemorrhage |
| title_full_unstemmed | Medial intracranial carotid artery calcifications and hematoma expansion in deep intracerebral hemorrhage |
| title_short | Medial intracranial carotid artery calcifications and hematoma expansion in deep intracerebral hemorrhage |
| title_sort | medial intracranial carotid artery calcifications and hematoma expansion in deep intracerebral hemorrhage |
| url | https://doi.org/10.1002/acn3.52240 |
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