원발성뇌출혈후뇌졸중의재발

Abstract

Department of Neurology, Seoul National University Boramae Hospital, & Seoul National UniversityDepartment of Neurology, Seoul National University Hospital, Seoul National University*,Department of Neurology, Eulji University Shool of Medicine** Background: Survivors of primary intracerebral hemorrhage (PICH) are at risk of either recurrent hemorrhageor ischemic stroke. This study was performed to determine the rate of recurrence and predictors of recurrent PICHor ischemic stroke. Methods: The patients who were admitted due to PICH and were followed up for more thanone month were included. Demographic and clinical information was collected from stroke registry and medicalrecords. Microbleeds on T2-weighted gradient-echo (GE) MRI, periventricular hyperintensities (PVH), lacunesand abnormal MRA findings were reviewed. Episodes of recurrent PICH or ischemic stroke, blood pressure andlipid profile during the follow-up period were also analyzed. Results: One hundred and seventeen patients wereincluded, and mean follow-up period was 21.2 months. Recurrence rate of PICH was 3.39%/year and andischemic stroke was 2.90%/year. Previous history of PICH (p=0.044) and presence of microbleeds (p=0.009) wereindependent predictors of recurrent PICH. Location of hemorrhage, hypertension, DM, hyperlipidemia, cardiacdisease and age showed no significant relationship with recurrence of stroke. PVH, lacunes and abnormal MRAwere not related with recurrent PICH or ischemic stroke. Conclusions: Recurrent stroke after PICH, either hemor-rhagic or ischemic, is not uncommon and previous history of PICH or microbleeds on MRI seems to have predict-ing value of recurrence of PICH. Predictors of ischemic stroke after PICH remain to be determined.