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Primary intracerebral hemorrhage (ICH) is responsible for about 50% of mortality related to stroke, and the majority of survivors are left with relevant disability, representing a major health and social issue. Cerebral small vessel disease (SVD) affects small arterioles, capillaries and veins in the brain. ...

Primary intracerebral hemorrhage (ICH) is responsible for about 50% of mortality related to stroke, and the majority of survivors are left with relevant disability, representing a major health and social issue. Cerebral small vessel disease (SVD) affects small arterioles, capillaries and veins in the brain. SVD causes around 20% of all strokes and is a major contributor to vascular dementia. SVD is also a cause of ICH, and insights about the overlap between the two conditions may improve the diagnosis and management of ICH, thereby reducing its health burden.

SVD in its diverse causes (i.e. arteriolosclerosis, amyloid related, monogenic) is a cause of ICH. We aim to explore the relationship between SVD and ICH with regards to causes, including genetic factors, diagnosis and classification (e.g. sporadic small vessel disease vs cerebral amyloid angiopathy) with a multidisciplinary approach. Genetic factors underlying SVD may clarify the pathologic mechanisms resulting in ICH. Chronic and acute imaging features together with genetic investigations may help clinicians diagnose SVD as the underlying cause of ICH. Prognostic factors in the hyperacute phase (particularly imaging, including contrast and non-contrast CT markers of hemorrhage expansion, small vessel disease burden) may help stratify prognostically and inform about possible complications with impact on management. SVD is an independent contributor of disability, cognitive disorders and neuropsychiatric disorders, and concurrent ICH may worsen the clinical trajectory. Identification of genetic, clinical, and imaging prognostic factors as well as putative therapies may help reduce the burden of disease.

In this Research Topic, we will focus only on clinical work, and we will welcome contributions related to SVD and ICH covering, but not limited to, the following themes:

• Classification and causes ICH: imaging findings of cerebral small vessel disease in intracerebral hemorrhage
• Intracerebral hemorrhage related to cerebral amyloid angiopathy
• Intracerebral hemorrhage related to sporadic small vessel disease
• Monogenic SVD as a cause of or risk for intracerebral hemorrhage
• Genetic epidemiology of SVD and intracerebral hemorrhage
• Hematoma Expansion
• Prediction of short and long-term clinical outcomes, including cognition and neuropsychiatric complications, in intracerebral hemorrhage related to small vessel disease
• Acute treatment and secondary prevention

Keywords: Small Vessel Disease, Intracerebral Hemorrhage, CT and MR Imaging, Hematoma Expansion, Genetic, Genetic Epidemiology, Outcomes, Cognition, Neuropsychiatric disorders, Disability


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