JNNP: Diffusion-weighted imaging lesions and the risk of stroke recurrence after intracerebral hemorrhage

Spontaneous intracerebral hemorrhage (ICH) occurs in millions of people worldwide every year
.

In most patients, the ICH is smaller cerebral vessels induced disease (SVD), affecting perforator small arteries of the brain

Vascular Stroke

Whether DWI+ lesions can predict clinical events after cerebral hemorrhage is still uncertain
.

In some studies, poor functional outcomes (assessed by the modified Rankin score 3 months after cerebral hemorrhage) are related to the presence of DWI+ lesions

The purpose of this article is to investigate whether DWI+ lesions in antithrombotic-related cerebral hemorrhage survivors are associated with recurrent strokes in a post-event exploratory subgroup analysis of restarting or stopping the randomized antithrombotic trial (REstart)

prevention

Research flow chart

Participants randomly start or avoid using the number minimization algorithm for antiplatelet therapy within 24 hours.
The algorithm minimizes the difference between the two experimental groups of participants based on five variables: (1) Randomized age (<70 years vs.
≥70 years) (2) Cerebral hemorrhage site (brain lobe and non-brain lobe) (3) Time after symptoms appear (7-30 days, >30 days) (4) Types of antiplatelet therapy (aspirin and others); (5) The probability of survival and independence at 6 months (<0.
15) and ≥0.
15)
.

Participants underwent MRI of the brain

Follow-up data will be collected after randomization until death or November 30, 2018, as described above
.

Ask each participant (or their representative) and their primary care physician if there are any serious vascular events, hospital admissions, life status, and medication use

Of the 247 participants, 73 (30%) had at least one DWI+ lesion
.

A total of 150 DWI+ lesions were found with an average diameter of 4 mm (IQR 3-6)

This article found that the presence of DWI+ lesions in ICH survivors in the trial was associated with recurrent ICH, but not with ischemic stroke
.

These findings provide a new perspective for the significance of DWI+ lesions.

This article found that the presence of DWI+ lesions in ICH survivors in the trial was associated with recurrent ICH, but not with ischemic stroke
.
These findings provide a new perspective for the significance of DWI+ lesions.
DWI+ lesions may be a marker of microvascular mechanisms related to cerebral hemorrhage recurrence
.
WiegertjesK ,Dinsmore  L ,  Drever  J Wiegertjes  K Wiegertjes Dinsmore  L Dinsmore Drever  J Drever , et al Diffusion-weighted imaging lesions and risk of recurrent stroke after intracerebral haemorrhage Journal of Neurology, Neurosurgery & Psychiatry  Published Online First:  08 June 2021.
  Published Online First: doi:  10.
1136/jnnp-2021-326116 doi: leave a message here