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Abstract Details

Cerebral Microbleeds and Acute Hematoma Characteristics in the ATACH-2 and MISTIE III Trials
Neuro Trauma, Critical Care, and Sports Neurology
Neurocritical Care Posters (7:00 AM-5:00 PM)
003
To study the relationship between the presence of cerebral microbleeds (CMBs) and acute hematoma characteristics among patients with intracerebral hemorrhage (ICH).
Markers of cerebral small vessel disease (CSVD), which includes both white matter hyperintensities and CMBs, are independently linked to poor outcomes after ICH. Prior studies have yielded conflicting results regarding the association between CMBs and acute hematoma characteristics.
We pooled individual patient data from the Antihypertensive Treatment of Acute Cerebral Hemorrhage 2 (ATACH-2) trial and the Minimally Invasive Surgery Plus Alteplase for Intracerebral Hemorrhage Evacuation phase 3 (MISTIE III) trial who had an available magnetic resonance imaging (MRI) scan. The exposure was presence of CMBs, defined as a low-signal intensity on gradient recalled echo or susceptibility-weighted imaging. The co-primary outcomes were log-transformed admission ICH volume and hematoma expansion. Mixed-effects linear and logistic regression models were used, with demographics and comorbidities considered fixed effects, and the study cohort treated as a random effect. Additional analyses entailed assessing the relationship between CMB topography and number, and hematoma characteristics.
Of the 1499 ICH patients, 466 (31.1%) had available MRIs and were included in the final analyses. CMBs were present in 231 (49.6%) of patients. In adjusted models, presence of CMBs was associated with smaller baseline hematoma volume (Beta, -0.26; 95% CI, -0.44 to -0.08; P=0.005) and decreased odds of hematoma expansion (OR, 0.65; 95% CI 0.40-0.95; P=0.04). The strength of association between CMBs and hematoma characteristics increased with increasing number of CMBs. Location of CMBs (lobar vs. deep) or severity of leukoaraiosis did not influence hematoma outcomes (all P>0.05).
In a pooled cohort of ICH patients, we found that presence of CMBs is associated with smaller baseline hematoma volume and lower odds of hematoma expansion. This knowledge may aid in tailoring acute ICH treatment approaches targeting hematoma expansion.
Authors/Disclosures
Jessica Magid-Bernstein, MD, PhD (Yale School of Medicine)
PRESENTER 		Dr. Magid-Bernstein has nothing to disclose.
David J. Roh, MD (Columbia University Medical Center) Dr. Roh has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Portola Pharmaceuticals.
No disclosure on file
Ashkan Shoamanesh, MD Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bayer AG. Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Daiichi Sankyo . Dr. Shoamanesh has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Servier Inc.. Dr. Shoamanesh has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Neurodiem.ca. The institution of Dr. Shoamanesh has received research support from Servier Canada Inc.. The institution of Dr. Shoamanesh has received research support from Daiichi Sankyo Ltd.. The institution of Dr. Shoamanesh has received research support from Bayer AG. The institution of Dr. Shoamanesh has received research support from Bristol-Myers Squibb. The institution of Dr. Shoamanesh has received research support from Octapharma Canada .
Sung-Min Cho No disclosure on file
Alexander Merkler, MD Dr. Merkler has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for The Neurohospitalist. Dr. Merkler has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for n/a.
No disclosure on file
No disclosure on file
Costantino Iadecola, MD (Weill Cornell Medicine) Dr. Iadecola has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Broadview Ventures.
Guido J. Falcone, MD (Yale School of Medicine) The institution of Dr. Falcone has received research support from NIH. The institution of Dr. Falcone has received research support from AHA.
Kevin N. Sheth, MD, FÂ鶹´«Ã½Ó³»­ (Yale UniversityDivision of Neuro and Critical Care) Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ceribell. Dr. Sheth has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll. Dr. Sheth has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NControl. Dr. Sheth has received stock or an ownership interest from Astrocyte. Dr. Sheth has received stock or an ownership interest from Alva. The institution of Dr. Sheth has received research support from Biogen. The institution of Dr. Sheth has received research support from Novartis. The institution of Dr. Sheth has received research support from Bard. The institution of Dr. Sheth has received research support from Hyperfine. Dr. Sheth has received intellectual property interests from a discovery or technology relating to health care.
Hamza I. Maqsood, MD (Dept of Neurology) Dr. Qureshi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for AstraZeneca.
Joshua Goldstein (Massachusetts General Hospital) Joshua Goldstein has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CSL Behring. The institution of Joshua Goldstein has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octapharma. Joshua Goldstein has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astrazeneca. The institution of Joshua Goldstein has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Takeda. The institution of Joshua Goldstein has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Octapharma. Joshua Goldstein has stock in NControl. Joshua Goldstein has stock in Cayuga. The institution of Joshua Goldstein has received research support from Pfizer. The institution of Joshua Goldstein has received research support from Takeda.
Jonathan Rosand, MD (Massachusetts General Hospital) Dr. Rosand has received personal compensation for serving as an employee of Massachusetts General Hospital. Dr. Rosand has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly and Co. Dr. Rosand has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Elsevier. The institution of Dr. Rosand has received research support from NIH. The institution of Dr. Rosand has received research support from American Heart Association. Dr. Rosand has received personal compensation in the range of $0-$499 for serving as a Peer reviewer with National Institutes of Health. Dr. Rosand has a non-compensated relationship as a Trustee with Columbia University that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.
Daniel F. Hanley, MD, FÂ鶹´«Ã½Ó³»­ (Johns Hopkins Medicine, Acute Care Neurology) Dr. Hanley has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Neurotrope. Dr. Hanley has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for various law firms. The institution of Dr. Hanley has received research support from NIH/NCATS. The institution of Dr. Hanley has received research support from NIH/NINDS.
Hooman Kamel, MD (Weill Cornell Medical College) Dr. Kamel has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Kamel has received personal compensation in the range of $50,000-$99,999 for serving as a Endpoint adjudication committee with Boehringer-Ingelheim.
Wendy C. Ziai, MD (Johns Hopkins Univ, Neuro Critical Care) Dr. Ziai has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Springer. Dr. Ziai has received research support from NIH. Dr. Ziai has received publishing royalties from a publication relating to health care. Dr. Ziai has received personal compensation in the range of $500-$4,999 for serving as a Consultant with DOJ.
Santosh B. Murthy, MD (Weill Cornell Medicine) Dr. Murthy has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for CarePoint. Dr. Murthy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alnylam. Dr. Murthy has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Stroke and Neurological disorders. The institution of Dr. Murthy has received research support from National Institutes of Health/NINDS.