Increasing age, pre-existing dementia, a history of intracerebral hemorrhage (ICH), ICH lobar location, severe white matter hyperintensities score, and an absence of lacune are independent clinical and radiologic markers associated with cortical superficial siderosis (cSS) and underlying cerebral amyloid angiopathy in patients with spontaneous ICH. These were the findings of a prospective observational study published in Neurology.
Vascular risk factors
Consecutive patients with parenchymal hemorrhage and spontaneous ICH from the observational Prognosis of IntraCerebral Haemorrhage (PITCH) study (n=258) were recruited. At baseline, the investigators prospectively obtained data on the presence of vascular risk factors, including whether the patients had a history of stroke or transient ischemic attack (TIA), ischemic heart disease, or atrial fibrillation. The Informant Questionnaire on Cognitive Decline in the Elderly, with a score of >64 defining pre-existing dementia, was used to obtain information on baseline cognitive function. Patients were invited to participant in an in-person or telephone-based follow-up at 6 and 12 months.
Prevalence of cSS
At baseline, the prevalence of cSS was 19% (n=49; 95% CI, 14%-24%). The clinical factors independently associated with cSS in the multivariable analysis included a history of ICH (odds ratio [OR] 4.02; 95% CI, 1.25-12.95; P =.020), increasing age (OR 1.03 per 1-year increase; 95% CI, 1.001-1.058; P =.044), and preexisting dementia (OR 2.62; 95% CI, 1.05-6.51; P =.044).
Radiologic factors that were deemed independent predictors for cSS included severe white matter hyperintensities score (OR 5.506; 95% CI, 1.17-5.78; P =.019), ICH lobar location (OR 24.841; 95% CI, 3.2-14.46; P <.001), and absence of lacune (OR 4.46; 95% CI 1.06-5.22; P =.035). In addition, recurrent symptomatic ICH was significantly associated with disseminated cSS on baseline magnetic resonance imaging (MRI) (hazard ratio 4.69; 95% CI, 1.49-14.71; P =.008).
Source: Neurology Advisor | August 14, 2018