AUTHOR=Yan Yujia , Ren Hecheng , Luo Bin , Fan Wanpeng , Zhang Xiqiang , Huang Ying 

TITLE=Clinical characteristics of spontaneous intracranial basal ganglia hemorrhage and risk factors for hematoma expansion in the plateaus of China

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1183125

DOI=10.3389/fneur.2023.1183125

ISSN=1664-2295

ABSTRACT=Background and Purpose
The clinical features of intracranial cerebral hemorrhage (ICH) and the risk factors for hematoma expansion (HE) have been extensively studied. However, few studies have been performed in the plateau patients. The natural habituation and genetic adaptation have resulted in differences in disease characteristics. The purpose of this study was to investigate the differences and consistency of clinical and imaging characteristics of patients in the plateau of China compared with the plain, and to analyze the risk factors for HE of intracranial hemorrhage in the plateau patients.

Methods
From January 2020 to August 2022, we undertook a retrospective analysis of 479 patients with first-episode spontaneous intracranial basal ganglia hemorrhage in Tianjin and Xining City. The Clinical, radiologic data during hospitalization were analyzed. Univariate and multivariate logistic regression analyses were used to assess the risk factors for HE.

Results
HE occurred in 31 plateau (36.0%) and 53 plain (24.2%) ICH patients, and HE was more likely to occur in the plateau compared with the plain (P=0.037). The NCCT images of patients in the plateau also showed heterogeneity of hematoma imaging signs, the incidence of blend sign (23.3% vs. 11.0%, P=0.043) and black hole sign (24.4% vs. 13.2%, P=0.018) was significantly higher than in the pain. Baseline hematoma volume, black hole sign, island sign, blend sign, PLT and HB level were associated with HE in the plateau. Baseline hematoma volume and the heterogeneity of hematoma imaging signs were independent predictors of HE in both the plain and plateau.

Conclusions
Compared with the plain, ICH patients in the plateau were more prone to HE. The patients showed the same heterogeneous signs on the NCCT images as in the plain, and also had predictive value for HE.