Association of Intracranial Dolichoectasia and Cerebral Small Vessel Disease in Patients With Intracerebral Hemorrhage
Background Intracranial arterial dolichoectasia (IADE) is associated with cerebral small vessel disease (CSVD) in populations with ischemic stroke. Whether IADE is related to CSVD markers in patients with intracerebral hemorrhage (ICH) is unclear but might be relevant for CSVD diagnosis and prognosi...
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Wiley
2025-06-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.039039 |
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| author | Kitti Thiankhaw Larysa Panteleienko Catriona R. Stewart Rupert Oliver Dermot Mallon Gareth Ambler David J. Werring |
| author_facet | Kitti Thiankhaw Larysa Panteleienko Catriona R. Stewart Rupert Oliver Dermot Mallon Gareth Ambler David J. Werring |
| author_sort | Kitti Thiankhaw |
| collection | DOAJ |
| description | Background Intracranial arterial dolichoectasia (IADE) is associated with cerebral small vessel disease (CSVD) in populations with ischemic stroke. Whether IADE is related to CSVD markers in patients with intracerebral hemorrhage (ICH) is unclear but might be relevant for CSVD diagnosis and prognosis. We aimed to investigate the prevalence and associations of IADE in patients with ICH. Methods We included consecutive patients with ICH between February 2016 and September 2023. IADE was determined using magnetic resonance angiography based on validated scales assessing vessel diameter, length, and tortuosity. Neuroimaging markers of CSVD were investigated using validated magnetic resonance imaging rating scales. Left ventricular mass (LVM) was determined from transthoracic echocardiography. Multivariable binary logistic regression analyses were used to evaluate associations between IADE and CSVD. Results We included 138 patients with a mean age of 66.7±11.8 years, 58.0% men. IADE was present in 16 patients (11.6%). LVM was greater in patients with IADE (183.0±61.3 g versus 155.3±51.2 g, P=0.04). Patients with ICH and IADE had significantly higher proportions of deep lacunes (43.8% versus 18.0%, P=0.02) and deep cerebral microbleeds (56.3% versus 27.1%, P=0.02) compared with individuals without IADE. IADE was independently associated with deep lacunes (adjusted odds ratio [OR], 3.10 [95% CI, 1.02–9.55], P=0.04), severe periventricular white matter hyperintensities (adjusted OR, 3.29 [95% CI, 1.00–10.94], P=0.04), and deep cerebral microbleeds (adjusted OR, 2.80 [95% CI, 1.04–8.65], P=0.04). Among these CSVD markers, IADE had a high predictive value for deep cerebral microbleeds with a receiver operating characteristic curve of 0.75 (95% CI, 0.66–0.85). There was no statistically significant association between IADE and lobar ICH (adjusted OR, 1.29 [95% CI, 0.36–4.64], P=0.70) or cerebral amyloid angiopathy (adjusted OR, 0.46 [95% CI, 0.13–1.67], P=0.24). Conclusions IADE is found in approximately 12% of patients with ICH and is independently associated with neuroimaging markers of arteriolosclerosis but not cerebral amyloid angiopathy. |
| format | Article |
| id | doaj-art-bb209db6e8fb43328ed0c453a8138841 |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Wiley |
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| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-bb209db6e8fb43328ed0c453a81388412025-08-20T03:50:00ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-06-01141210.1161/JAHA.124.039039Association of Intracranial Dolichoectasia and Cerebral Small Vessel Disease in Patients With Intracerebral HemorrhageKitti Thiankhaw0Larysa Panteleienko1Catriona R. Stewart2Rupert Oliver3Dermot Mallon4Gareth Ambler5David J. Werring6Stroke Research Centre, Department of Brain Repair and Rehabilitation University College London Queen Square Institute of Neurology London United KingdomStroke Research Centre, Department of Brain Repair and Rehabilitation University College London Queen Square Institute of Neurology London United KingdomStroke Research Centre, Department of Brain Repair and Rehabilitation University College London Queen Square Institute of Neurology London United KingdomNational Hospital for Neurology and Neurosurgery University College London Hospitals NHS Foundation Trust London United KingdomDepartment of Neuroradiology, National Hospital for Neurology and Neurosurgery London United KingdomDepartment of Statistical Science, Faculty of Mathematical & Physical Sciences University College London London United KingdomStroke Research Centre, Department of Brain Repair and Rehabilitation University College London Queen Square Institute of Neurology London United KingdomBackground Intracranial arterial dolichoectasia (IADE) is associated with cerebral small vessel disease (CSVD) in populations with ischemic stroke. Whether IADE is related to CSVD markers in patients with intracerebral hemorrhage (ICH) is unclear but might be relevant for CSVD diagnosis and prognosis. We aimed to investigate the prevalence and associations of IADE in patients with ICH. Methods We included consecutive patients with ICH between February 2016 and September 2023. IADE was determined using magnetic resonance angiography based on validated scales assessing vessel diameter, length, and tortuosity. Neuroimaging markers of CSVD were investigated using validated magnetic resonance imaging rating scales. Left ventricular mass (LVM) was determined from transthoracic echocardiography. Multivariable binary logistic regression analyses were used to evaluate associations between IADE and CSVD. Results We included 138 patients with a mean age of 66.7±11.8 years, 58.0% men. IADE was present in 16 patients (11.6%). LVM was greater in patients with IADE (183.0±61.3 g versus 155.3±51.2 g, P=0.04). Patients with ICH and IADE had significantly higher proportions of deep lacunes (43.8% versus 18.0%, P=0.02) and deep cerebral microbleeds (56.3% versus 27.1%, P=0.02) compared with individuals without IADE. IADE was independently associated with deep lacunes (adjusted odds ratio [OR], 3.10 [95% CI, 1.02–9.55], P=0.04), severe periventricular white matter hyperintensities (adjusted OR, 3.29 [95% CI, 1.00–10.94], P=0.04), and deep cerebral microbleeds (adjusted OR, 2.80 [95% CI, 1.04–8.65], P=0.04). Among these CSVD markers, IADE had a high predictive value for deep cerebral microbleeds with a receiver operating characteristic curve of 0.75 (95% CI, 0.66–0.85). There was no statistically significant association between IADE and lobar ICH (adjusted OR, 1.29 [95% CI, 0.36–4.64], P=0.70) or cerebral amyloid angiopathy (adjusted OR, 0.46 [95% CI, 0.13–1.67], P=0.24). Conclusions IADE is found in approximately 12% of patients with ICH and is independently associated with neuroimaging markers of arteriolosclerosis but not cerebral amyloid angiopathy.https://www.ahajournals.org/doi/10.1161/JAHA.124.039039cerebral microbleeddolichoectasiaintracerebral hemorrhagelacunesmall vessel diseasewhite matter hyperintensity |
| spellingShingle | Kitti Thiankhaw Larysa Panteleienko Catriona R. Stewart Rupert Oliver Dermot Mallon Gareth Ambler David J. Werring Association of Intracranial Dolichoectasia and Cerebral Small Vessel Disease in Patients With Intracerebral Hemorrhage Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease cerebral microbleed dolichoectasia intracerebral hemorrhage lacune small vessel disease white matter hyperintensity |
| title | Association of Intracranial Dolichoectasia and Cerebral Small Vessel Disease in Patients With Intracerebral Hemorrhage |
| title_full | Association of Intracranial Dolichoectasia and Cerebral Small Vessel Disease in Patients With Intracerebral Hemorrhage |
| title_fullStr | Association of Intracranial Dolichoectasia and Cerebral Small Vessel Disease in Patients With Intracerebral Hemorrhage |
| title_full_unstemmed | Association of Intracranial Dolichoectasia and Cerebral Small Vessel Disease in Patients With Intracerebral Hemorrhage |
| title_short | Association of Intracranial Dolichoectasia and Cerebral Small Vessel Disease in Patients With Intracerebral Hemorrhage |
| title_sort | association of intracranial dolichoectasia and cerebral small vessel disease in patients with intracerebral hemorrhage |
| topic | cerebral microbleed dolichoectasia intracerebral hemorrhage lacune small vessel disease white matter hyperintensity |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.039039 |
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