Relationship Between Cerebral Small Vessel Disease And Perihematomal Edema In Patients With Intracerebral Hemorrhage

Objective:To investigate the relationship between perihematoma edema and the subtypes of cerebral small vessel disease(SVD)and the total SVD burden in patients with spontaneous intracerebral hemorrhage(ICH).Methods:Eighty-five patients with ICH within 24 hours after onset in the First Affiliated Hospital of Henan University of Science and Technology from August 2013 to August2017 were admitted.Clinical basic records,laboratory data,results of CT scan in 24 hours,3-5 days,10-14 days and cranial MRI results were collected.The hematoma volume and edema volume at different times after onset were calculated,and the severity of lacune(LA),white matter hypertensities(WMH),enlarged perivascular space(EPVS),cerebral microbleeds(CMB)and the total SVD burden were assessed.Linear regression was conducted to analyse the relationship between perihematoma edema and each marker and the total burden of SVD.Results:1.In the multivariable linear regression model of hematoma volume after adjusted age,blood pressure,admission GCS score and admission NIHSS score,there was a positive correlation between CMB number and hematoma volume,and a negative correlation between Fazekas score and hematoma volume.2.In the multivariable linear regression model of edema volume which adjusted age,blood pressure,admission GCS score,admission NIHSS score and hematoma volume,there was a negative correlation between EPVS and edema volume.3.The total SVD burden was not correlated with the perihematoma edema volume within 24 hours after ICH,but it was negatively correlated with the edema volume at 3-14 days.Conclusions:1.Hematoma expands with the increase of CMB number and the decrease of Fazekas score.2.The presence of EPVS may be a sign of mild perihematoma edema.3.The total SVD burden can predict the severity of perihematoma edema between 3 and 14 days.