Background

Concomitant asymptomatic striatocapsular slit-like hemorrhage (SSH) is occasionally found in patients of spontaneous intracerebral hemorrhage (ICH), but was seldomly described in the literature. In this study, we described the clinico-radiological features of asymptomatic SSH in ICH patients with hypertensive microangiopathy.

Methods and Results

246 patients with strictly deep or mixed deep and lobar ICH/microbleeds were included. SSH was defined as hypointense lesions involving the lateral aspect of lentiform nucleus or external capsule in slit shape (>1.5 cm) on susceptibility-weighted imaging without history of associated symptoms. Demographics and neuroimaging markers were compared between patients with SSH and those without. Patients with SSH (n=24, 10%) and without SSH had comparable age (62.0 ± 12.6 vs. 62.3 ± 13.5, p = 0.912) and vascular risk factor profiles including the diagnosis of chronic hypertension, diabetes, and dyslipidemia (all p>0.05). SSH was associated with more common lobar microbleeds (79.2% vs 48.2%, p = 0.005), lacunes (75% vs. 41.4%, p = 0.002) and higher white matter hyperintensity (WMH) volumes (24.1 [10.4–46.3] vs. 13.9 [7.0–24.8] mL, p = 0.012) on MRI, as well as more frequent left ventricular hypertrophy (LVH) (50.0% vs. 20.5%, p = 0.004) and albuminuria (41.7% vs. 19.4%, p = 0.018). In multivariable analyses, SSH remains independently associated with LVH (p = 0.017) and albuminuria (p = 0.032) after adjustment for age, sex, microbleed, lacune and WMH volume.

Conclusions

Asymptomatic SSH is associated with more severe cerebral small vessel disease-related change on brain MRI, and hypertensive cardiac and renal injury, suggesting a more advanced stage of chronic hypertension.

中文翻译：

---

高血压血管病患者的无症状纹状体囊状裂隙样出血为严重程度指标。

背景

自发性脑出血（ICH）患者偶尔会出现无症状的纹状体囊膜狭缝样出血（SSH），但文献中很少对此进行描述。在这项研究中，我们描述了无症状SSH在ICH高血压微血管病患者中的临床放射学特征。

方法与结果

包括246例严格的深部或混合性深部和大叶ICH /微出血患者。SSH被定义为涉及敏感性样加权成像而无裂痕状（> 1.5 cm）的半形核或外囊侧面的低位病变，无相关症状史。比较了有SSH的患者和没有SSH的患者的人口统计学和神经影像标记。患有SSH（n = 24，10％）而没有SSH的患者具有可比较的年龄（62.0±12.6 vs. 62.3±13.5，p  = 0.912）和包括早期高血压，糖尿病和血脂异常的诊断在内的血管危险因素特征（所有p > 0.05）。SSH与更常见的肺叶微出血（79.2％vs 48.2％，p  = 0.005），腔隙（75％vs.41.4％，p = 0.002）和MRI上较高的白质高强度（WMH）量（24.1 [10.4–46.3] vs. 13.9 [7.0–24.8] mL，p  = 0.012），以及更常见的左心室肥大（LVH）（50.0％对比20.5％，p  = 0.004）和蛋白尿（41.7％对比19.4％，p  = 0.018）。在多变量分析中， 在对年龄，性别，微出血，腔隙和WMH量进行调整后，SSH仍与LVH（p  = 0.017）和蛋白尿（p = 0.032）保持独立相关。

结论

无症状SSH与更严重的脑小血管疾病相关的脑MRI改变以及高血压性心脏和肾脏损伤有关，提示慢性高血压病的晚期。