PURPOSE Hypoperfusion in the perihematomal rim is common in acute intracerebral hemorrhage (ICH) but its determinants remain incompletely characterized. Despite known biological differences between deep and lobar ICH, the association between ICH location and cerebral perfusion has not been investigated. We tested the hypothesis that perihematomal perfusion differs between deep and lobar ICH. METHODS Prospectively collected cohort of subjects with primary spontaneous ICH undergoing CT perfusion on admission. Cerebral blood flow (CBF), blood volume (CBV), and mean transit time (MTT) were measured in the manually outlined perihematomal low-density area. The association between perihematomal perfusion and ICH location was explored with multivariable linear regression. RESULTS A total of 155 patients were enrolled (59 with a lobar bleeding). In univariate analysis, median perihematomal CBF and CBV were lower in lobar ICH compared with deep ICH (23.8 vs 33.4 mL/100 g/min, p = 0.001 and 1.7 vs 2.3 mL/100 g, p = 0.001, respectively). Lobar ICH location remained inversely associated with CBF (β = - 0.17, p = 0.038) and CBV (β = - 0.19, p = 0.023) after adjustment for confounders in linear regression. CONCLUSION Lobar ICH location is inversely related with perihematomal CBF and CBV. Further studies are needed to confirm this association and define the underlying biological mechanisms.

中文翻译：

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深部和大叶性脑出血的血肿周围灌注比较。

目的在急性脑出血（ICH）中，血肿周围边缘的灌注不足很常见，但其决定因素仍不完全明确。尽管深部和大叶ICH之间存在已知的生物学差异，但尚未研究ICH位置与脑灌注之间的关联。我们检验了假性血流灌注在深部和大叶ICH之间不同的假设。方法前瞻性收集入院时接受CT灌注的原发性自发性ICH受试者的队列。在人工勾画的血肿周围低密度区域中测量了脑血流量（CBF），血容量（CBV）和平均通过时间（MTT）。通过多变量线性回归探讨了血肿周围灌注与ICH位置之间的关系。结果共纳入155例患者（其中59例为大叶出血）。在单变量分析中，大叶ICH的中位血肿周围CBF和CBV低于深部ICH（分别为23.8 vs 33.4 mL / 100 g / min，p = 0.001和1.7 vs 2.3 mL / 100 g，p = 0.001）。调整线性回归因素后，大叶ICH位置与CBF（β=-0.17，p = 0.038）和CBV（β=-0.19，p = 0.023）呈负相关。结论大叶脑出血的位置与血周CBF和CBV成反比。需要进一步的研究以确认这种关联并定义潜在的生物学机制。023）在调整线性回归中的混杂因素后。结论大叶脑出血的位置与血周CBF和CBV成反比。需要进一步的研究以确认这种关联并定义潜在的生物学机制。023）在调整线性回归中的混杂因素后。结论大叶脑出血的位置与血周CBF和CBV成反比。需要进一步的研究以确认这种关联并定义潜在的生物学机制。