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Peri-hematomal edema shape features related to 3-month outcome in acute supratentorial intracerebral hemorrhage

Dierksen, Fiona; Tran, Anh T; Zeevi, Tal; Maier, Ilko L; Qureshi, Adnan I; Sanelli, Pina C; Werring, David J; ... Payabvash, Seyedmehdi; + view all (2024) Peri-hematomal edema shape features related to 3-month outcome in acute supratentorial intracerebral hemorrhage. European Stroke Journal 10.1177/23969873231223814. (In press). Green open access

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Abstract

Introduction: Perihematomal edema (PHE) represents secondary brain injury and a potential treatment target in intracerebral hemorrhage (ICH). However, studies differ on optimal PHE volume metrics as prognostic factor(s) after spontaneous, non-traumatic ICH. This study examines associations of baseline and 24-h PHE shape features with 3-month outcomes. // Patients and methods: We included 796 patients from a multicentric trial dataset and manually segmented ICH and PHE on baseline and follow-up CTs, extracting 14 shape features. We explored the association of baseline, follow-up, difference (baseline/follow-up) and temporal rate (difference/time gap) of PHE shape changes with 3-month modified Rankin Score (mRS) – using Spearman correlation. Then, using multivariable analysis, we determined if PHE shape features independently predict outcome adjusting for patients’ age, sex, NIH stroke scale (NIHSS), Glasgow Coma Scale (GCS), and hematoma volume. // Results: Baseline PHE maximum diameters across various planes, main axes, volume, surface, and sphericity correlated with 3-month mRS adjusting for multiple comparisons. The 24-h difference and temporal change rates of these features had significant association with outcome – but not the 24-h absolute values. In multivariable regression, baseline PHE shape sphericity (OR = 2.04, CI = 1.71–2.43) and volume (OR = 0.99, CI = 0. 98–1.0), alongside admission NIHSS (OR = 0.86, CI = 0.83–0.88), hematoma volume (OR = 0.99, CI = 0. 99–1.0), and age (OR = 0.96, CI = 0.95–0.97) were independent predictors of favorable outcomes. // Conclusion: In acute ICH patients, PHE shape sphericity at baseline emerged as an independent prognostic factor, with a less spherical (more irregular) shape associated with worse outcome. The PHE shape features absolute values over the first 24 h provide no added prognostic value to baseline metrics.

Type: Article
Title: Peri-hematomal edema shape features related to 3-month outcome in acute supratentorial intracerebral hemorrhage
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1177/23969873231223814
Publisher version: http://dx.doi.org/10.1177/23969873231223814
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Intracerebral hemorrhage; perihematomal edema; sphericity; hemorrhagic stroke
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Brain Repair and Rehabilitation
URI: https://discovery.ucl.ac.uk/id/eprint/10186191
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