J Stroke.  2014 Sep;16(3):184-188. 10.5853/jos.2014.16.3.184.

Arterial Stiffness in Patients with Deep and Lobar Intracerebral Hemorrhage

• Acampa M
• Guideri F
• Di Donato
• Tassi R
• Marotta G
• Lo Giudice G
• D'Andrea P
• Martini G

• KMID: 2223703
• DOI: http://doi.org/10.5853/jos.2014.16.3.184

Abstract

BACKGROUND AND PURPOSE
Intracerebral hemorrhage (ICH) accounts for approximately 10% of stroke cases. Hypertension may play a role in the pathogenesis of ICH that occurs in the basal ganglia, thalamus, pons, and cerebellum, but not in that of lobar ICH. Hypertension contributes to decreased elasticity of arteries, thereby increasing the likelihood of rupture in response to acute elevation in intravascular pressure. This study aimed to evaluate arterial stiffness (using the arterial stiffness index [ASI]) in patients with deep (putaminal and thalamic) ICH in comparison with patients with lobar ICH.
METHODS
We enrolled 64 patients (mean+/-SD age: 69.3+/-10.7 years; 47 men and 17 women) among 73 who referred consecutively to our department for intraparenchymal hemorrhage and underwent brain computed tomography (CT) and cerebral angio-CT. In all the subjects, 24-hour heart rates and blood pressures were monitored. The linear regression slope of diastolic on systolic blood pressure was assumed as a global measure of arterial compliance, and its complement (1 minus the slope), ASI, has been considered as a measure of arterial stiffness.
RESULTS
In the patients with deep ICH, ASI was significantly higher than in the patients with lobar ICH (0.64+/-0.19 vs. 0.53+/-0.17, P=0.04).
CONCLUSIONS
Our results suggest that in deep ICH, arterial stiffening represents a possible pathogenetic factor that modifies arterial wall properties and contributes to vascular rupture in response to intravascular pressure acute elevation. Therapeutic strategies that reduce arterial stiffness may potentially lower the incidence of deep hemorrhagic stroke.

Keyword

Hemorrhagic stroke; Intracerebral hemorrhage; Deep cerebral hemorrhage; Lobar cerebral hemorrhage; Arterial stiffness; Arterial hypertension

MeSH Terms

Arteries
Basal Ganglia
Blood Pressure
Brain
Cerebellum
Cerebral Hemorrhage*
Complement System Proteins
Compliance
Elasticity
Heart Rate
Hemorrhage
Humans
Hypertension
Incidence
Linear Models
Male
Pons
Rupture
Stroke
Thalamus
Vascular Stiffness*
Complement System Proteins