Abstract T P322: Risk Factors for Vascular Lesions as Etiology of Intraventricular Hemorrhage in Prospectively Screened Cases
Introduction: Previous studies have used inconsistent screening thresholds and modalities for detecting vascular lesions as the cause of intraventricular hemorrhage (IVH). We aimed to characterize demographic and ethnicity risks of harboring vascular lesions in a cohort of prospectively identified IVH cases with systematic screening for underlying vascular etiology.
Methods: Patients with IVH were identified from the database of Clot Lysis: Evaluation Accelerated Resolution of Intraventricular Hemorrhage Phase III (CLEAR III) clinical trial. It included patients age 18-80 years with obstructive IVH with or without associated intracerebral hemorrhage (ICH) less than 30 ml in volume. This cohort study compared 447 patients enrolled in CLEAR, who were screened negative for underlying vascular lesion (no lesion), and 1276 patients with IVH concurrently screened and excluded from CLEAR because of underlying lesion (vascular lesion).
Results: Mean age was lower in patients with vascular lesion (55 vs. 59; p<.001), with a greater difference in patients with vascular malformations (47 versus 58, p<.001) and Moyamoya disease (45 versus 58, p<.001), and there was no difference in age of patients with aneurysms versus no lesion (mean age 59 in both groups). Male prevalence was lower (lesion: 42%, no lesion: 55%; p<.001), with a higher prevalence in those with vascular malformations than those with aneurysm (56% versus 35%, p<.001) and Moyamoya disease (56% versus 39%, p=0.074). The prevalence of Whites was higher (lesion: 60%, no lesion: 51%; p<.001) and that of African-Americans lower (lesion: 11%, no lesion: 33%; p<.001). The prevalence of patients with primary IVH as opposed to IVH with intracerebral hemorrhage (ICH) was higher among patients with lesions (lesion: 21%, no lesion: 15%; p=.003).
Conclusion: IVH patients with an underlying vascular lesion tend to be significantly younger, more likely female, White, and harbor primary IVH. The younger age is attributed to vascular malformations or Moyamoya disease, rather than aneurysm. Patients with lesion may have exhibited other characteristic features of hemorrhage not addressed in this study.
Author Disclosures: A. Pang: None. S. Mayo: None. A. Stadnik: None. M. Jesselson: None. L. Zhang: None. R. Dlugash: None. D. Hanley: None. I. Awad: None.
- © 2015 by American Heart Association, Inc.