Abstract TP296: Leukoaraiosis on MRI Correlates with Worse Outcomes after Intracerebral Hemorrhage
Background: Leukoaraiosis (LA) is associated with aging, dementia, ischemic stroke, and intracerebral hemorrhage (ICH), but there are few data on how LA might impact outcomes after ICH. We tested the hypothesis that the severity of LA on MRI is related to worse functional outcomes after spontaneous ICH.
Methods: We prospectively identified patients with spontaneous ICH. LA was identified on MRI and its severity graded using the Fazekas method to include a score for the deep white matter (DWM) and periventricular (PV) regions. Outcomes were obtained at 14 days, 28 days, and 3 months with the modified Rankin Scale (mRS, a validated scale from 0, no symptoms, to 6, dead), analyzed with multivariate ordinal and logistic regression.
Results: Higher Fazekas total (PV+DWM) score correlated with higher mRS at 14 days (p=0.02) and 3 months (p=0.02). This relationship was driven by the PV score, for which higher score (more severe disease) correlated with higher NIHSS at 14 days (p=0.03), and higher mRS at 14 days (p<0.001), 28 days (p=0.004), and 3 months (p=0.005). The relationship persisted after correction for the ICH score (OR 1.8 for mRS>3 per point on Fazekas PV, 95% CI 1.02-3.2, p=0.04).
Conclusion: Increased severity of LA in PV regions is an independent predictor of worse functional outcomes in patients after spontaneous ICH. The pathophysiology associating LA with worse outcomes requires further study. These data may improve prognostication and selection for clinical trials.
- © 2012 by American Heart Association, Inc.