Hematoma size in deep intracerebral hemorrhage and its correlation with dot-like hemosiderin spots on gradient echo T2*-weighted MRI.
OBJECTIVE
Dot-like low intensity spots (dot-like hemosiderin spots: dotHSs) on gradient echo T2*-weighted MRI have been histologically diagnosed to represent old cerebral microbleeds associated with microangiopathies. They have also been correlated to the fragility of small vessels and the tendency to bleed. Therefore, a substantial number of dotHSs might be associated with a large-sized, deep intracerebral hematoma (ICH). On the other hand, dotHSs may reflect old microbleeds that did not enlarge to symptomatic size.


METHODS
To investigate how dotHSs are related to the size (maximal diameter) of primary deep ICH, we analyzed the diameter and the number of dotHSs in 151 patients with deep ICH not associated with subarachnoid hemorrhage or intraventricular hemorrhage (75 males and 76 females, age ranged from 37 to 90 [65.7 +/- 11.3 years old] who were consecutively admitted to Hakodate Municipal Hospital. The hazard ratio (HR) for a maximal diameter of deep ICH < or =2 cm was estimated, using the number of dotHSs and risk factors for stroke.


RESULTS
The number of dotHSs associated with the diameter < or =2 cm was 9.2 +/- 11.5, significantly larger than that with the diameter > or =2 cm (4.7 +/- 7.0, P= .012). Multivariate analysis revealed that a maximal diameter of deep ICH of < or =2 cm was found in patients with dotHS (HR, 3.7; 95% confidence interval [CI], 1.4-10.1; P= .009).


CONCLUSIONS
Though small sample size limited the power of our analyses, these findings suggest that the number of dotHSs may be associated with a small diameter of deep ICH.
Imaizumi
Toshio
T
Department of Neurosurgery, Kushiro City General Hospital, 1-12 Shunkodai, Kushiro, Hokkaido 085-0822, Japan. timaizum@d9.dion.ne.jp
Honma
Toshimi
T
Horita
Yoshifumi
Y
Kohama
Ikuhide
I
Miyata
Kei
K
Kawamura
Maiko
M
Niwa
Jun
J
D000368:Aged; D001921:Brain / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000473:pathology*; D016009:Chi-Square Distribution; D005260:Female; D006406:Hematoma / Q000473:pathology*; D006485:Hemosiderin / Q000032:analysis*; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018709:Statistics, Nonparametric
D006485:Hemosiderin