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London, United Kingdom 2013 32 Intracerebral/subarachnoid haemorrhage and venous diseases The risk of recurrent intracerebral haemorrhage and vaso-occlusive events after a first-ever primary spontaneous intracerebral haemorrhage – a prospective community-based study N. Samarasekera1, A. Fonville2, C. Lerpiniere3, A. Farrall4, P. White5, J. Wardlaw6, C. Smith7, R. Al-Shahi Salman8 for the the Lothian Audit of the Treatment of Cerebral Haemorrhage (LATCH) collaborators Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UNITED KING-DOM1, Academic Medical Centre, University of Amsterdam, Amsterdam, THE NETHERLANDS2, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UNITED KINGDOM3, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UNITED KINGDOM4, In-stitute for Ageing & Health, Newcastle University, Newcastle-upon-Tyne, UNITED KINGDOM5, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UNITED KINGDOM6, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UNITED KINGDOM7, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UNITED KINGDOM8 Background – Survivors of spontaneous intracerebral haemorrhage (ICH) are at risk of both recur-rent ICH as well as vaso-occlusive events, which we sought to quantify over one year following first-ever ICH and investigate whether ICH location affected these risks. Methods – We used multiple overlapping sources of ascertainment to identify every adult diagnosed between 1 June 2010 and 31 May 2011 with a first-ever ICH that was not apparently secondary to an underlying cause (based on neuroradiologist review of brain imaging and/or post mortem exam-ination), whilst they were resident in the Lothian Health Board region of Scotland (population aged >/=16 years 695,335). We used multiple methods in primary and secondary care to follow survivors over one year for symptomatic outcome events (recurrent ICH, ischaemic stroke, transient ischaemic attack, myocardial infarction, pulmonary embolism, or deep vein thrombosis). Results – 128 adults had a first-ever ICH, 68 of which involved one or more lobar brain regions. 55 (43%) adults died within 30 days. During 63 person-years of follow-up (97% completeness) there were four recurrent ICHs, all of which were lobar and occurred exclusively in survivors of lobar ICH (annual risk 5.9%, 95% confidence interval CI 2.3% to 15.1%; p=0.04). The annual risk of vaso-occlusive events (n=10) was 15.1% (95% CI 8.3% to 26.6%), which did not appear to differ between adults with lobar ICH (16.2%, 95% CI 7.0% to 34.8%) and non-lobar ICH (14.4%, 95% CI 6.1% to 31.9%; p=1.00). For all adults, regardless of ICH location, vaso-occlusive events seemed to be more frequent than recurrent ICH in the first year (hazard ratio 2.66, 95% CI 0.83-8.48, p=0.08). Conclusions – In the first year after ICH, the risk of vaso-occlusive events seemed to be higher than recurrent ICH (but ICH location influenced only the risk of recurrent ICH), which creates dilemmas about the use of antithromobotic drugs after ICH. E-Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 599 31 Intracerebral/subarachnoid haemorrhage and venous diseases Retinal arteriole-to-venule ratio in intracerebral haemorrhage subtypes and lacunar infarc-tion M. Söderholm1, J. Petersson2, E. Zia3 Clinical sciences Malmö, Lund University, Malmö, SWEDEN1, Department of Neurology, Skåne university hospital, Malmö, SWEDEN2, Clinical sciences Malmö, Lund University, Malmö, SWE-DEN3 Background It has been suggested that the vascular lesions underlying intracerebral haemorrhage (ICH) are different in nonlobar and lobar ICH, whereas a similar pathology, referred to as small vessel disease, might cause both nonlobar ICH and lacunar infarction. Evaluation of retinal vessel width may provide a non-invasive approach to study the vascular pathology in stroke subtypes. We evaluated retinal arteriole-to-venule ratio (AVR) in patients with lobar and nonlobar ICH, lacunar infarction and stroke-free controls. Methods Consecutive patients ≤ 70 years admitted to the Skåne University Hospital, Malmö, Sweden, with first-ever ICH or lacunar infarction were included and underwent retinal photography. The arteriole and venule widths were measured using a computer-ized technique, and the AVR was compared between stroke subtypes, and between each stroke sub-type and stroke-free controls, randomly selected from the general population. Results 23 patients with nonlobar ICH, 8 with lobar ICH, 25 with lacunar infarction and 23 controls were included. Mean age (±SD) was 59±9 years in stroke patients and 58±8 years in controls. Mean AVR was 0.76±0.1 in stroke patients and 0.78±0.1 in controls. Mean AVR was somewhat, although insignifi-cantly, lower in patients with lacunar infarction as compared with controls (0.74 vs. 0.78, p=0.107), and also as compared with nonlobar ICH patients (0.74 vs. 0.79, p=0.069). Adjustment for cardio-vascular risk factors in a general linear model did not markedly influence these results. In all other comparisons between subgroups (controls vs. lobar ICH, controls vs. nonlobar ICH, lacunar infarc-tion vs. lobar ICH, and nonlobar vs. lobar ICH), mean AVRs were similar and p values>0.4. Conclu-sions The hypothesis of similar AVR in lacunar infarction and nonlobar ICH patients, as a surrogate for the same vascular pathology, was not supported by the results in this study. The low number of stroke subtypes, especially lobar ICHs, is a limitation.


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