Contrast leakage distant from the hematoma in patients with spontaneous ICH: A 7 T MRI study
Jolink, Wilmar MT; Lindenholz, Arjen; van Etten, Ellis S; van Nieuwenhuizen, Koen M; Schreuder, Floris Hbm; Kuijf, Hugo J; van Osch, Matthias Jp; Hendrikse, Jeroen; Rinkel, Gabriel Je; Wermer, Marieke JH; Klijn, Catharina JM
(2020) Journal of Cerebral Blood Flow and Metabolism, volume 40, issue 5, pp. 1002 - 1011
(Article)
Abstract
Disruption of the blood-brain barrier (BBB) might play a role in the pathophysiology of cerebral small vessel disease-related ICH. The aim of this study was to assess presence and extent of contrast agent leakage distant from the hematoma as a marker of BBB disruption in patients with spontaneous ICH. We
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prospectively performed 7 tesla MRI in adult patients with spontaneous ICH and assessed contrast leakage distant from the hematoma on 3D FLAIR images. Thirty-one patients were included (mean age 60 years, 29% women). Median time between ICH and MRI was 20 days (IQR 9-67 days). Seventeen patients (54%; seven lobar, nine deep, one infratentorial ICH) had contrast leakage, located cortical in 16 and cortical and deep in one patient. Patients with contrast leakage more often had lobar cerebral microbleeds (CMBs; 77%) than those without (36%; RR 2.5, 95% CI 1.1-5.7) and a higher number of lobar CMBs (patients with contrast leakage: median 2, IQR 1-8 versus those without: median 0, IQR 0-2; p = 0.02). This study shows that contrast leakage distant from the hematoma is common in days to weeks after spontaneous ICH. It is located predominantly cortical and related to lobar CMBs and therefore possibly to cerebral amyloid angiopathy.
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Keywords: Blood–brain barrier, cerebral microbleeds, intracerebral hemorrhage, magnetic resonance imaging, small vessel disease, Blood-brain barrier, Clinical Neurology, Neurology, Cardiology and Cardiovascular Medicine, Journal Article
ISSN: 0271-678X
Publisher: Nature Publishing Group
Note: Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Dr. Klijn is supported by a clinical established investigator grant of the Dutch Heart Foundation (Grant Number 2012T077) and an ASPASIA grant from The Netherlands Organisation for Health Research and Development, ZonMw (grant number 015008048) Publisher Copyright: © The Author(s) 2019. Copyright: Copyright 2020 Elsevier B.V., All rights reserved.
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