Higher Cerebral Blood Flow Predicts Early Hematoma Expansion in Patients With Intracerebral Hemorrhage: A Clinical Study

Weijing Wang; Weitao Jin; Hao Feng; Guoliang Wu; Wenjuan Wang; Jiaokun Jia; Ruijun Ji; Anxin Wang; Xingquan Zhao

doi:10.3389/fneur.2021.735771

Higher Cerebral Blood Flow Predicts Early Hematoma Expansion in Patients With Intracerebral Hemorrhage: A Clinical Study

Front Neurol. 2021 Dec 6:12:735771. doi: 10.3389/fneur.2021.735771. eCollection 2021.

Authors

Weijing Wang^{1

2

3}, Weitao Jin⁴, Hao Feng^{1

5

6}, Guoliang Wu⁷, Wenjuan Wang^{1

5

6}, Jiaokun Jia^{1

5

6}, Ruijun Ji^{1

5

6}, Anxin Wang¹, Xingquan Zhao^{1

5

6}

Affiliations

¹ Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
² Department of Neurology, Beijing Haidian Hospital, Beijing, China.
³ Department of Neurology, Haidian Section of Peking University Third Hospital, Beijing, China.
⁴ Department of Neurosurgery, Peking University International Hospital, Beijing, China.
⁵ China National Clinical Research Center for Neurological Diseases, Beijing, China.
⁶ Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China.
⁷ Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.

Abstract

The early hematoma expansion of intracerebral hemorrhage (ICH) indicates a poor prognosis. This paper studies the relationship between cerebral blood flow (CBF) around the hematoma and hematoma expansion (HE) in the acute stage of intracerebral hemorrhage. A total of 50 patients with supratentorial cerebral hemorrhage were enrolled in this study. They underwent baseline whole-brain CTP within 6 h after intracerebral hemorrhage, and non-contrast CT within 24 h. Absolute hematoma growth and relative hematoma growth were calculated, respectively. A relative growth of Hematoma volume >33% was considered to be hematoma expansion. The Ipsilateral peri-edema CBF and Ipsilateral edema CBF were calculated by CTP maps in patients with and without hematoma expansion, respectively. In this study the incidence of hematoma expansion in the early stage of supratentorial cerebral hemorrhage was 32%; The CBF of the hematoma expansion group was higher than that of the patients without hematoma expansion (23.5 ± 12.5 vs. 15.1 ± 7.4, P = 0.004). After adjusting for age, gender, Symptom onset to NCCT and Baseline hematoma volume, ipsilateral peri-edema CBF was still an independent risk factor for early HE (or = 1.095, 95% CI = 1.01-1.19, P = 0.024). Here, we concluded that higher cerebral blood flow predicts early hematoma expansion in patients with intracerebral hemorrhage.

Keywords: CT perfusion (CTP); cerebral blood flow (CBF); hematoma expansion; intracerebral hemorrhage; prognosis.