Added Value of Cerebral Small Vascular Disease Burden Based On MRI for Prediction Poor Outcome of Intracerebral Hemorrhage.

Background: The significance between cerebral small vessel disease (CSVD) markers on MRI and clinical outcome in intracerebral hemorrhage (ICH) patients is unclear. This study aimed to explore the connection between CSVD markers and short-term outcome in ICH patients.

Methods: We retrospectively included 318 ICH patients. Patients were categorized into unfavorable and favorable prognosis groups based on their 90-day modified Rankin Scale (mRS) score (mRS > 3 indicates unfavorable). We conducted an MRI-based assessment of CSVD markers and investigated the predictive power of individual markers and the overall burden on prognosis.

Results: White matter hyperintensities (WMH) with a modified Fazekas score ≥ 2 (95% CI 2.367-17.421, p < 0.001), the presence of cortical superficial siderosis (CSS) (95 % CI 2.582-28.212, p < 0.001 in Model 1; 95 % CI 2.701-27.385, p < 0.001 in Model 2), and total CSVD burden (95 % CI 1.249-2.352, p < 0.05) are independent risk factors for unfavorable outcome of ICH.

Conclusions: MRI-based markers of CSVD are valuable in assessing the risk of poor outcome in ICH. WMH with a modified Fazekas score ≥ 2, the presence of CSS, and higher CSVD burden are independently associated with adverse functional outcome.