Journal
ARCHIVES OF NEUROLOGY
Volume 67, Issue 10, Pages 1224-1230Publisher
AMER MEDICAL ASSOC
DOI: 10.1001/archneurol.2010.249
Keywords
-
Categories
Funding
- National Health and Medical Research Council [352337]
- National Health & Medical Research Council Senior Research Fellowship [2005-2014]
- NSW Health
Ask authors/readers for more resources
Background: The vascular pathogenesis underlying lobar intracerebral hemorrhage (ICH) is unclear. Objective: To determine whether certain retinal microvascular signs are associated with lobar ICH to improve understanding of its underlying cerebral vasculopathy. Design: Prospective cohort study. Setting: Royal Melbourne Hospital and Westmead Hospital. Patients: Of 655 patients with acute stroke, 25 had lobar ICH, 51 had deep ICH, 93 had lacunar infarction, and 486 had nonlacunar cerebral infarction. Main Outcome Measures: Retinal photographs were assessed for retinopathy lesions (microaneurysms, retinal hemorrhages, cotton-wool spots, and hard exudates) and retinal arteriolar wall signs (focal arteriolar narrowing, arteriovenous nicking, and enhanced arteriolar wall light reflex) masked to the cerebral pathologic abnormalities and the study hypothesis. Results: In patients without diabetes mellitus, retinopathy lesions were more likely to be present in persons with lobar ICH than in those with either lacunar infarction (47.8% vs 30.4%; adjusted odds ratio, 3.5; 95% confidence interval, 1.1-10.9) or nonlacunar cerebral infarction (47.8% vs 24.6%; 3.3; 1.4-8.1). Most retinal arteriolar wall signs were less frequent in lobar ICH than in deep ICH, although this difference was significant only for focal arteriolar narrowing. Conclusions: Patients with lobar ICH were more likely than patients with lacunar or nonlacunar cerebral infarction to have retinopathy lesions, suggesting breakdown of the blood-retina barrier in patients with lobar ICH. These findings support a distinct vasculopathy in lobar ICH compared with other acute stroke subtypes resulting from cerebral small vessel disease or ischemic infarction.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available