Association Between Cerebral Small Vessel Disease and Risk of Recurrent ICH Among U.S. Minority Survivors
by Priyanka Senthil
Abstract – Introduction: Compared to White survivors of Intracerebral Hemorrhage (ICH), Black/Hispanic individuals are three times more likely to experience ICH recurrence. Cerebral Small Vessel Disease (CSVD) has long been considered a risk factor for ICH. Our study sought to clarify whether differences in CSVD subtype or severity among minority and White individuals could explain this disparity. Methods: We collected data of ICH survivors from the MGH-ICH and ERICH studies. MRI scans were analyzed for CSVD markers as classified by cerebral microbleeds (CMBs). CSVD was identified as either Cerebral Amyloid Angiopathy (CAA) subtype or Arteriolo-Sclerosis (AS) subtype. Results: We analyzed data from the total 2192. When compared to Whites, a higher percentage of minority individuals had markers of CSVD on MRI scans (54% vs. 41%, p<0.001). There was a greater count (higher burden) of AS-associated CMBs in minorities (median: 1, IQR 1-2 vs. median 0, IQR 0-1, p=0.016). Conclusion: Minority ICH survivors are not only more likely to present with CSVD at the time of stroke, but they also have a higher burden of specifically associated CMBs.
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