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    Home > Active Ingredient News > Study of Nervous System > JOS: Cerebral venous return of hypertensive intracerebral hemorrhage can lead to widening of the perivascular space of the basal ganglia and recurrence of stroke!

    JOS: Cerebral venous return of hypertensive intracerebral hemorrhage can lead to widening of the perivascular space of the basal ganglia and recurrence of stroke!

    • Last Update: 2022-11-14
    • Source: Internet
    • Author: User
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    Spontaneous intracerebral hemorrhage (ICH) is a devastating stroke that refers to intra-sulci hemorrhage
    caused by a damaged arteriole or arterial vessel rupture.
    Cerebral small vessel disease (SVD), especially hypertensive SVD, is the most common underlying lesion
    of ICH.
    Typical imaging findings on conventional magnetic resonance imaging (MRI) reflecting parenchymal injury to SVD include cerebral microhemorrhage, white matter hyperplasia (WMHs), fissures, and enlargement
    of the perivascular spaces (PVSs) of the basal ganglia (BG).
    Although
    While chronic hypertension, aging, and other vascular risk factors contribute to the development of cerebral arteriosclerotic changes in hypertensive ICH, the underlying pathogenesis may be multifaceted and in many ways remains unknown
    .

    The study included 297 hypertensive
    patients with intracerebral hemorrhage (ICH) who underwent magnetic resonance imaging.
    Cerebral venous return (CVR) is defined as the presence of abnormal signal intensity
    in the dural venous sinuses or internal jugular veins on time-of-flight angiography.
    Scholars from Taiwan investigated the relationship between
    CVR, dilated perivascular space (PVS) and the risk of recurrent stroke.

    The results showed that 38 (12.
    8%) patients developed CVR
    .
    Patients with CVR were more likely to have more (number>20) dilated PVS in the basal ganglia than those without CVR (60.
    5% vs.
    35.
    1%; OR=2.
    64; 95% confidence interval [CI], 1.
    25 to 5.
    60; P=0.
    011) and large PVS (diameter>3 mm) (50.
    0% vs.
    18.
    5%; aOR, 3.
    87; 95% CI, 1.
    85 to 8.
    09; P<0.
    001).

    During a median follow-up of 18 months, patients with CVR had a higher rate of recurrent stroke than those without CVR (13.
    6%/year vs.
    6.
    2%/year; aOR=2.
    53; 95% CI, 1.
    09 to 5.
    84; P=0.
    03).

    In summary, CVR may contribute to the formation of enlarged PVS and increase the risk of
    recurrent stroke in patients with hypertensive ICH.

     

    References:

    Cerebral Venous Reflux and Dilated Basal Ganglia Perivascular Space in Hypertensive Intracerebral Hemorrhage.
    DOI: https://doi.
    org/10.
    5853/jos.
    2022.
    01004

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