Predictive factors for intracerebral hemorrhage in patients with cavernous angiomas.
OBJECTIVE
Prediction of intracerebral hemorrhage (ICH) in patients with cavernous angiomas is not totally elucidated. The aims of our study were to determine the rate of cerebral hemorrhage, its associated factors, and the clinical outcome in patients with cavernous angiomas in a Hispanic population.


METHODS
We studied 133 patients with cavernous angiomas. The patients were classified into two groups depending on whether they presented an ICH. A comparative analysis of demographics and clinical data, neuroimaging characteristics, and prognosis was carried out in patients with and without hemorrhage. The hemorrhage rate (expressed as the percentage per patient per year) was also estimated.


RESULTS
Seventy-eight patients (59%) had hemorrhage. Non-lobar location of angiomas was associated with hemorrhage [OR 4.82 (CI 95% 2.17-10.73; p=<0.001)]. In contrast, factors associated with a decreased risk of hemorrhage were a family history of epilepsy [OR 0.30 (CI 95% 0.10-0.79; p=0.016)] and lobar location of the angiomas [OR 0.21 (CI 95% 0.09-0.46; p=<0.001)]. The hemorrhagic rate of 1.71% per patient per year was influenced by the location. It was only 1.22% per patient per year in lobar angiomas and 2.33, 2.39, and 2.82% per patient per year for brainstem, cerebellum, and deep hemispheric angiomas, respectively.


CONCLUSIONS
The non-lobar location of cavernous angiomas gives a higher risk of hemorrhage in our Mexican mestizo population, without the hemorrhage being related to either age or sex.
Cantu
Carlos
C
Stroke Clinic, Manuel Velasco Suarez National Institute of Neurology and Neurosurgery, Insurgentes Sur 3877, Colonia La Fama, Delegación Tlalpan, Mexico, DF, CP 14269.
Murillo-Bonilla
Luis
L
Arauz
Antonio
A
Higuera
Jesús
J
Padilla
Joel
J
Barinagarrementeria
Fernando
F
D000328:Adult; D002543:Cerebral Hemorrhage / Q000453:epidemiology* / Q000209:etiology*; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale / Q000706:statistics & numerical data; D006392:Hemangioma, Cavernous / Q000145:classification / Q000150:complications*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012306:Risk