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14 January 2019 : Clinical Research  

New Silent Cerebral Infarction in Patients with Acute Non-Cerebral Amyloid Angiopathy Intracerebral Hemorrhage as a Predictor of Recurrent Cerebrovascular Events

Yuan-Wei Wang1ABCDEF, Guo-Ming Zhang2ABCDEFG*

DOI: 10.12659/MSM.914423

Med Sci Monit 2019; 25:418-426

Abstract

BACKGROUND: The aim of this study was to investigate the incidence and related risk factors of new silent cerebral infarction in patients with acute non-cerebral amyloid angiopathy (non-CAA) intracerebral hemorrhage (ICH) and to explore clinical cerebrovascular event recurrence within 1 year.

MATERIAL AND METHODS: This prospective study observed 152 patients with non-CAA ICH diagnosed by computed tomography within 3 days after onset. All patients underwent magnetic resonance imaging on day 14 to identify silent cerebral infarction, and their subsequent clinical cerebrovascular events were followed up regularly within 1 year.

RESULTS: Of the 152 patients, 46 (30.26%) had silent cerebral infarctions. Multiple logistic regression analysis revealed that the white blood cell (WBC) count, cerebral microbleeds (CMBs), and leukoaraiosis were silent cerebral infarction risk factors. At 1-year follow-up, 34 (22.37%) had clinical cerebrovascular events, with 8 (23.53%) having vascular-related deaths. Multiple logistic regression analysis showed that silent cerebral infarction was the only independent predictor of future clinical cerebrovascular events.

CONCLUSIONS: Silent cerebral infarction is common during acute non-CAA ICH and is independently related to WBC counts, CMBs, and leukoaraiosis. The risk of clinical cerebrovascular events in non-CAA ICH patients with silent cerebral infarction increases in the following year; thus, silent cerebral infarction may be a useful predictor of recurrent cerebrovascular events.

Keywords: Cerebral Amyloid Angiopathy, Cerebral Small Vessel Diseases, Leukoaraiosis, Aged, 80 and over, Brain, Cerebral Hemorrhage, cerebral infarction, Magnetic Resonance Imaging, Prospective Studies, Recurrence, Risk Factors, Stroke, Tomography, X-Ray Computed

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750