Hemorrhagic Manifestations of Reversible Cerebral Vasoconstriction Syndrome Frequency, Features, and Risk Factors

Hemorrhagic Manifestations of Reversible Cerebral Vasoconstriction Syndrome Frequency, Features, and Risk Factors
复制标题

DOI：
10.1161/strokeaha.109.572313
复制
发表时间：
2010-11-01
期刊：
STROKE
影响因子：
8.3
通讯作者：
Bousser, Marie-Germaine
Bousser, Marie-Germaine
中科院分区：
医学1区
文献类型：
--
作者：
Ducros, Anne;Fiedler, Ursula;Bousser, Marie-Germaine

文献摘要

被引文献

相似文献

背景和目的：可逆性脑血管收缩综合征（RCVS）以严重头痛和可逆性脑动脉收缩为特征，可能与缺血性和出血性卒中有关。本研究的目的是描述的频率，模式，和危险因素的颅内出血RCVS。方法，我们分析了前瞻性数据，89例连续RCVS，其中8个产后和46个使用血管活性物质。标准的双变量和多变量的统计检验，比较患者和没有hemorrhages.Results-Thirty例（34%），其中5个是产后和12个使用血管活性物质，开发至少1种类型的颅内出血，包括皮质蛛网膜下腔（n=27），脑内（n=11），和硬膜下出血（n=2）。出血患者的年龄较大（46.6岁vs 41.6岁，P=0.049），女性（90% vs 51%，P=0.0017）或偏头痛患者（43% vs 19%，P=0.022）多于未出血患者。多变量检验确定了RCVS出血的2个独立危险因素：女性（OR，4.05; 95%CI，1.46 - 11.2）和偏头痛（OR，2.34; 95%CI，1.06 - 5.18）。出血患者在急性期发生持续性局灶性功能障碍（30%对2%，P=0.0002）、脑梗死（13%对2%，P=0.039）、可逆性后部脑病综合征（17%对3%，P=0.041）和6个月时无法恢复正常活动（27%对0%，P= 0.001）的风险更高。
Background and Purpose-Reversible cerebral vasoconstriction syndrome (RCVS), characterized by severe headaches and reversible constriction of cerebral arteries, may be associated with ischemic and hemorrhagic strokes. The aim of this study was to describe the frequency, patterns, and risk factors of intracranial hemorrhages in RCVS.Methods-We analyzed prospective data on 89 consecutive patients with RCVS, of which 8 were postpartum and 46 used vasoactive substances. Standard bivariate and multivariate statistical tests were applied to compare patients with and without hemorrhage.Results-Thirty patients (34%), of which 5 were postpartum and 12 used vasoactive substances, developed at least 1 type of intracranial hemorrhage, including cortical subarachnoid (n=27), intracerebral (n=11), and subdural hemorrhage (n=2). Patients with hemorrhage had an older age (46.6 versus 41.6 years, P=0.049) and were more frequently females (90% versus 51%, P=0.0017) or were migrainers (43% versus 19%, P=0.022) than those without hemorrhage. Multivariate testing identified 2 independent risk factors of hemorrhage in RCVS: female gender (OR, 4.05; 95% CI, 1.46 to 11.2) and migraine (OR, 2.34; 95% CI, 1.06 to 5.18). Patients with hemorrhage had a greater risk of persistent focal deficits (30% versus 2%, P=0.0002), cerebral infarction (13% versus 2%, P=0.039), posterior reversible encephalopathy syndrome (17% versus 3%, P=0.041) at the acute stage, and of inability to resume normal activities at 6 months (27% versus 0%, P