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Front. Hum. Neurosci. | doi: 10.3389/fnhum.2018.00471

The Impact of intracerebral hemorrhage on the Progression of white matter hyperintensity

 Xuemei Chen1*, Xin Chen2, Yan Chen2, Manman Xu2 and Junrong Li1*
  • 1Nanjing Jiangning Hospital, China
  • 2Department of Neurology, Nanjing Drum Tower Hospital, China

OBJECTIVE: The exact relationship between white matter hyperintensity (WMH) and intracerebral hemorrhage (ICH) after ICH remains unclear. In this retrospective study, we investigated whether patients with ICH had more severe WMH progression.
PATIENTS AND METHODS: A total of 2951 patients aged ≥ 40 years with ICH who received brain computed tomography (CT) imaging within 12 hours of ICH symptom onset were screened. Ninety patients with two fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) assessments, including 36 patients with Lobar ICH, 40 with basal ganglia region ICH, and 14 with ICH at other sites, were included in the final study. We selected 90 age- and gender-matched healthy individuals with two MRI scans as the control group. The WMH volume at baseline and follow-up was assessed using the FLAIR image by MRICRON and ITK-SNAP software, while the hematoma volumes were calculated based on the CT images using ITK-SNAP software.
RESULTS: The annual progression rate of WMH was significantly higher in the ICH group compared with the control group (p<0.05). Furthermore, WMH progression was associated with the ICH volume. The largest ICH volume (>30 mL)was associated with the highest annual progression rate of WMH (p<0.05). In contrast, no trend toward an association between ICH location and the annual progression rate of WMH was observed (p>0.05).
CONCLUSIONS: Our results showed that ICH patients had more severe WMH progression and that larger ICH volume was related to greater progression of WMH after ICH. These results could provide important prognostic information about patients with ICH.

Keywords: intracerebral hemorrhage, white matter injury, Hematoma, White matter hyperintensity, quantitative analysis

Received: 14 Aug 2018; Accepted: 09 Nov 2018.

Edited by:

Juan Zhou, Duke-NUS Medical School, Singapore

Reviewed by:

Dong-Hoon Lee, University of Sydney, Australia
Claudia Altamura, Università Campus Bio-Medico, Italy  

Copyright: © 2018 Chen, Chen, Chen, Xu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Prof. Xuemei Chen, Nanjing Jiangning Hospital, Nanjing, China, 13347808579@189.cn
Prof. Junrong Li, Nanjing Jiangning Hospital, Nanjing, China, ljry612@163.com