Dot-like hemosiderin deposition on T2*-weighted MR imaging associated with nonhypertensive intracerebral hemorrhage.
OBJECTIVE
Microangiopathy, a disorder often related to hypertension, is an important cause of deep intracerebral hematoma (ICH). The microangiopathy is associated with dot-like low-intensity spots (a dot-like hemosiderin spot: dotHS) on gradient-echo T2*-weighted MR images that have been histologically diagnosed as old microbleeds. The locations of dotHS are consistent with deep ICH.


METHODS
To investigate how dotHS or other risk factors contribute to nonhypertensive deep ICH, the number and location of dotHSs, as well as other risk factors were examined in 213 deep ICH patients (106 males, 107 females, age: 37-94 (65.8 +/- 11.2) years) consecutively admitted to Hakodate Municipal Hospital. Patients were divided into two subgroups according to the presence or absence of hypertension. DotHSs were also divided into deep and subcortical dotHS and investigated independently. Odds ratios (ORs) were estimated from logistic regression analyses. Furthermore, nonhypertensive ICH patients were compared with nonhypertensive healthy volunteers matched for age and sex.


RESULTS
No risk factors were identified in the 31 nonhypertensive deep ICH patients that differed from those found in the 182 hypertensive deep ICH patients. Deep dotHS > or = 1 (OR: 25.5; 95% CI: 4.76-137; P = .0002), subcortical dotHS > or = 1 (OR: 9.0; 95% CI: 1.79-44.9; P = .046), diabetes mellitus (OR: 9.0; 95% CI: 1.53-52.3; P = .015), and smoking (OR, 9.6; 95% CI; 1.8-49.8, P = .007) significantly elevated the risk of nonhypertensive ICH, compared to the healthy volunteers.


CONCLUSIONS
Our findings suggest that deep and subcortical dotHSs may be risk factors for the development of non-hypertensive deep ICH.
Department of Neurosurgery, Hakodate Municipal Hospital, 1-10-1 Minato-cho, Hakodate, Hokkaido, Japan. timaizum@d9.dion.ne.jp
Toshio
T
Imaizumi
Yoshifumi
Y
Horita
Masahiko
M
Chiba
Kei
K
Miyata
Kentaro
K
Toyama
Kazuhisa
K
Yoshifuji
Yuji
Y
Hashimoto
Jun
J
Niwa
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000473:pathology*; D016009:Chi-Square Distribution; D005260:Female; D006485:Hemosiderin / Q000032:analysis*; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D018709:Statistics, Nonparametric
D006485:Hemosiderin