Severe cerebral small vessel disease burden is associated with intraventricular extension of intracerebral hemorrhage.

OBJECTIVES

Factors associated with intraventricular extension (IE) following intracerebral hemorrhage (ICH) are not fully clarified. We aimed to elucidate the correlation between IE and cerebral small vessel disease (SVD) in ICH.

MATERIALS &

METHODS

Consecutive patients with acute ICH between July 2012 and November 2023 were screened. The inclusion criteria: 1) onset to door time within 7 days; 2) availability of SVD evaluation using total SVD score; and 3) availability of IE evaluation on admission and/or more than 24 h after admission. Total SVD score was calculated as the sum of the points for the following observations: old lacunes, white matter hyperintensity (WMH), cerebral microbleeds (CMBs), and enlarged perivascular spaces.

RESULTS

Of 608 ICH screened, 449 (234 [52 %] males, median age 75 years) were included. IE was observed in 151 (34 %). Total SVD score was independently associated with IE (prevalence ratio (PR) 1.188, 95 % confidence interval (CI) 1.063-1.329, p = 0.002). Further, a positive linear trend was observed between total SVD score and IE relative to a total SVD score of 0 (total SVD score 0: PR 1.000, total SVD score 1-2: PR 3.769, total SVD score 3-4: PR 4.109, p = 0.011 for trend). Among the items comprising the total SVD score, WMH (PR 1.406 95 % CI 1.041-1.899, p = 0.026) and CMBs (PR 1.800, 95 % CI 1.068-3.036, p = 0.027) were associated with IE.

CONCLUSION

In acute ICH, higher total SVD score is associated with IE. In particular, WMH and CMBs might correlate with the occurrence of IE.