Research Advancements on the Correlation Between Spontaneous Intracerebral Hemorrhage of Different Etiologies and Imaging Markers of Cerebral Small Vessel Disease

Abstract

Objective

The purpose of this review is to identify the correlation between ICH and CSVD imaging markers under SMASH-U classification by searching and analyzing a large number of literatures in recent years, laying a theoretical foundation for future clinical research. At the same time, by collecting clinical data to evaluate patient prognosis, analyzing whether there are differences or supplements between clinical trial conclusions and previous theories, and ultimately guiding clinical diagnosis and treatment through the analysis of imaging biomarkers.

Methods

In this review, by searching CNKI, Web of Science, PubMed, FMRS and other databases, the use of “spontaneous intracerebral hemorrhage”, “hypertensive hemorrhagic cerebral small vessel disease”, “cerebral small vessel disease imaging”, “Based cerebral small vessel diseases”, “SMASH the -u classification” and their Chinese equivalents for the main search term. We focused on reading and analyzing hundreds of relevant literatures in the last decade from August 2011 to April 2020, and also included some earlier literatures with conceptual data sources. After screening and ranking the degree of relevance to this study, sixty of them were cited for analysis and elaboration.

Results

In patients with ICH, the number of cerebral microbleeds in lobes, basal ganglia, and the deep brain is positively correlated with ICH volume and independently correlated with neurological functional outcomes; white matter hyperintensity severity is positively correlated with ICH recurrence risk; multiple lacunar infarction independently predict the risk of ICH; severe brain atrophy is an independent risk factor for a poor prognosis in the long term in patients diagnosed with ICH; and the number of enlarged perivascular spaces is correlated with ICH recurrence. However, small subcortical infarct and ICH are the subject of few studies. Higher CSVD scores are independently associated with functional outcomes at 90 days in patients diagnosed with ICH.

Keywords:

• amyloid angiopathy intracerebral hemorrhage
• hereditary cerebral small vessel disease
• hypertensive intracerebral hemorrhage
• imaging markers of cerebral small vessel disease
• SMASH-U classification

Abbreviation

ICH, intracerebral hemorrhage; CSVD, cerebral small vessel disease; RSSI, recent small subcortical infarct; LA, lacune; WMH, white matter hyperintensity; CMB, cerebral microbleed; BA, brain atrophy; LI, lacunar infarction; VRS, visual rating scale; HICH, hypertensive intracerebral hemorrhage; CAA, cerebral amyloid angiopathy; CAAH, cerebral amyloid angiopathy hemorrhage; hCSVD, hereditary cerebral small vessel disease; COL4A1, collagen type IV α1; COL4A2, collagen type IV α2; SMASH-U, Structural lesion, Medication, Amyloid angiopathy, Systemic/other disease, Hypertension, Undetermined; MRI, magnetic resonance imaging; T1WI, T1-weighted images; T2WI, T2-weighted images; SWI, susceptibility-weighted imaging; DWI, diffusion-weighted imaging; FLAIR, fluid-attenuated inversion recovery.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

The Major Science and Technology Special Project of Yunnan Province (202102AA100061) High-level health technicians of Yunnan Province (leading talents) L-2019018.