Specific Lobar Affection Reveals a Rostrocaudal Gradient in Functional Outcome in Spontaneous Intracerebral Hemorrhage [Clinical Sciences]

Background and Purpose—Several studies have reported a better functional outcome in lobar intracerebral hemorrhage (ICH) compared with deep location. However, among lobar ICH, a correlation of hemorrhage site—involving the specific lobes—with functional outcome has not been established.Methods—Conservatively treated patients with supratentorial ICH, admitted to our hospital over a 5-year period (2008–2012), were retrospectively analyzed. Lobar patients were classified as isolated or overlapping ICH according to affected lobes. Demographic, clinical, and radiological characteristics were recorded and compared among lobar ICH patients using above subclassification. Functional outcome—dichotomized into favorable (modified Rankin Scale, 0–3) and unfavorable (modified Rankin Scale, 4–6)—was assessed after 3 and 12 months. Multivariate regression analysis was performed to identify predictors for favorable outcome.Results—Of overall 553 patients, 260 had lobar ICH. In isolated lobar ICH, median hematoma-volume decreased from rostral (frontal, 22.4 mL [7.3–55.5 mL]) to caudal (occipital, 7.1 mL [5.2–16.4 mL]; P=0.045), whereas the proportion of patients with favorable outcome increased (frontal: 23/63 [36.5%] versus occipital: 10/12 [83.3%]; P=0.003). Patients with overlapping lobar ICH had larger ICH volumes than isolated lobar ICH (overlapping, 48.9 mL [22.6–78.5 mL] versus 15.3 mL [5.0–44.6 mL]; P
Source: Stroke - Category: Neurology Authors: Tags: Imaging, Prognosis, Quality and Outcomes, Intracranial Hemorrhage Original Contributions Source Type: research