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About 80% of nontraumatic intracerebral hemorrhages (ICH) are caused by bleeding-prone cerebral small vessel disease (SVD), and the proportion may be higher in older patients
Figure 1: Paper cover image
Cerebral amyloid angiopathy (CAA) causes lobar ICH, but not all lobar ICHs are caused by CAA
More recently, CT-based diagnostic criteria for CAA (the Edinburgh CAA criteria) have been developed that overcome the limitations associated with the use of MRI
Little is known about hematoma expansion in participants with intracerebral hemorrhage due to different types of ICH, and the effect of tranexamic acid may vary depending on the underlying arterial disease
From this, David J Seiffge et al.
Hematoma location and presence of cerebral amyloid angiopathy (CAA) were analyzed using CT and MRI (Edinburgh/Boston criteria), and ICH was classified into lobar CAA, lobar non-CAA, and nonlobar CAA
Of 2325 participants, 2298 were included in CT (98.
For HE, they found a significant relationship between lobar CAA ICH and time from onset to randomization (risk increased with time; p-interaction < 0.
Figure 2: The results of the paper
Tranexamic acid significantly reduced the risk of HE (aOR 0.
The significance of this study is the finding that patients with lobar CAA-ICH have no independent increase in the risk of HE, but appear to have different dynamics compared with other types of ICH
Original source:
