Neural Regeneration Research ›› 2022, Vol. 17 ›› Issue (4): 819-823.doi: 10.4103/1673-5374.322469

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Leukoaraiosis is associated with clinical symptom severity, poor neurological function prognosis and stroke recurrence in mild intracerebral hemorrhage: a prospective multi-center cohort study

Tian-Qi Xu1, #, Wei-Zhi Lin2, #, Yu-Lan Feng3, Fan-Xia Shen1, 4, Jie Chen1, Wei-Wen Wu5, Xiao-Dong Zhu6, Lin Gu7, *, Yi Fu1, *   

  1. 1Department of Neurology, Ruijin Hospital/Luwan Branch, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; 2The Third Affiliated People’s Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian Province, China; 3Department of Neurology, Minhang Hospital, Fudan University, Shanghai, China; 4Department of Neurology, Ruijin North Hospital, Shanghai, China; 5Department of Neurology, Zhongshan Hospital Qingpu Branch, Fudan University, Shanghai, China; 6Department of Neurology, The First Hospital of Jiaxing, Jiaxing, Zhejiang Province, China; 7Department of Rehabilitation, Shanghai Ruijin Rehabilitation Hospital, Shanghai, China
  • Online:2022-04-15 Published:2021-10-18
  • Contact: i Fu, MD, fuyiki@sina.com; Lin Gu, MS, gulin365@126.com.
  • Supported by:
    The study was supported by the National Natural Science Foundation of China, Nos. 81771281 (to FXS), 81471177 (to FXS); and the Natural Science Foundation of Shanghai of China, No. 20ZR1434200 (to YF).

Abstract: Leukoaraiosis (LA) results from ischemic injury in small cerebral vessels, which may be attributable to decreased vascular density, reduced cerebrovascular angiogenesis, decreased cerebral blood flow, or microcirculatory dysfunction in the brain. In this study, we enrolled 357 patients with mild intracerebral hemorrhage (ICH) from five hospitals in China and analyzed the relationships between LA and clinical symptom severity at admission, neurological function prognosis at 3 months, and 1-year stroke recurrence. Patients were divided into groups based on Fazekas scale scores: no LA (n = 83), mild LA (n = 64), moderate LA (n = 98) and severe LA (n = 112). More severe LA, larger hematoma volume, and higher blood glucose level at admission were associated with more severe neurological deficit. More severe LA, older age and larger hematoma volume were associated with worse neurological function prognosis at 3 months. In addition, moderate-to-severe LA, admission glucose and symptom-free cerebral infarction were associated with 1-year stroke recurrence. These findings suggest that LA severity may be a potential marker of individual ICH vulnerability, which can be characterized by poor tolerance to intracerebral attack or poor recovery ability after ICH. Evaluating LA severity in patients with mild ICH may help neurologists to optimize treatment protocols. This study was approved by the Ethics Committee of Ruijin Hospital Affiliated to Shanghai Jiao Tong University (approval No. 12) on March 10, 2011. 

Key words: clinical symptom severity, functional dependence, intracerebral hemorrhage, leukoaraiosis, modified Rankin scale, National Institute Health of Stroke Scale, prognosis, stroke recurrence, white matter hyperintensities

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