Analysis Of Risk Factors And Prognosis With Cerebral Hemorrhage Patients Accompanied By Cortical Superficial Siderosis

Background and Objectives:Cortical superficial siderosis(cSS)is an imaging symptom of hemosiderin deposition after intracranial microbleeds.Hypertensive cerebral hemorrhage and cerebral amyloid angiopathy(CAA)related cerebral hemorrhage account for about 90% of spontaneous cerebral hemorrhage.This article explores the imaging diagnosis of cerebral small vessel disease and related factors of cerebral hemorrhage,as well as their assessment of the condition and the impact on prognosis.To investigate the influence of subcortical hemosiderin deposition on the risk factors of patients with cerebral vascular amyloidosis-related cerebral hemorrhage Methods:We performed this prospective study on the patients diagnosed as ICH within 3 days after onset and MRI was performed in 5 days to detect lesions of CSS,cerebral microbleeds(CMBs)and leukoaraiosis(LA).Patients were regularly followed up one year for subsequent clinical cerebrovascular events and vascular related death.Results:241 patients with cerebral hemorrhage were enrolled,including 185 cases of deep hemorrhage and 56 cases of lobar hemorrhage.The proportion of CSS in lobar hemorrhage was more than that in deep hemorrhage(13,23.2% vs 12,6.5%,P<0.001).According to the modified Boston criteria,42 patients(17.4%)were possible CAA.During the follow-up of 1 year,35(14.5%)patients had clinical cerebrovascular events or death,and 13(31.0%)possible CAA patients had recurrent cerebral hemorrhage.Kaplan-Meier showed a higher risk of recurrent cerebral hemorrhage in possible CAA accompanied by cSS(c2=7.466,P=0.006).The multivariate COX regression model still found that cSS was an independent predictor of recurrent cerebral hemorrhage in patients with possible CAA(HR 4.45;95% CI 1.37-14.48,P=0.013).Conclusion:The prevalence of cSS in patients with lobar hemorrhage was higher than that in deep bleeding.Possible CAA accompanied by cSS had an increased risk of recurrent cerebral hemorrhage within the one year.