Age, education, initial conscious level, stroke severity, ICH volume, and lobar CMB burden were associated with early post-stroke cognition in Chinese ICH patients in Taiwan, with lobar ICH patients showing worse outcomes across multiple clinical and neuroimaging measures.
Non-lobar ICH was substantially more common than lobar ICH in this Taiwanese Chinese cohort.
Non-lobar ICH patients had a significantly higher proportion of hypertension compared to lobar ICH patients.
Lobar ICH patients had worse clinical outcomes and neuroimaging burden compared to non-lobar ICH patients.
Similar clinical and neuroimaging differences were observed when comparing cerebral amyloid angiopathy (CAA) versus non-CAA ICH groups.
Age, education, initial conscious level, stroke severity, ICH volume, and lobar CMB burden were independently associated with early post-stroke global cognitive performance after ICH.
This research studied 202 patients in Taiwan who had a type of stroke caused by bleeding in the brain (intracerebral hemorrhage, or ICH). The researchers compared patients whose bleeding occurred in the outer regions of the brain (lobar) versus deeper regions (non-lobar), and also compared those whose bleeding was caused by a condition called cerebral amyloid angiopathy (CAA) versus other causes. They found that the vast majority of patients (80%) had non-lobar ICH, which was strongly linked to high blood pressure. In contrast, patients with lobar ICH tended to be older, had more severe strokes, larger bleeds, and worse thinking and memory function shortly after their stroke. The study also identified six factors that were linked to how well patients could think and reason in the early period after their stroke: older age, lower education level, worse level of consciousness at the start, greater stroke severity, larger bleed volume, and a higher burden of tiny bleeding spots in the outer brain regions (called lobar cerebral microbleeds). These microbleeds, visible on brain scans, suggest underlying damage to small blood vessels and appear to play a role in cognitive outcomes beyond just the immediate stroke. This research suggests that early cognitive problems after a brain bleed are shaped by both the immediate characteristics of the stroke and pre-existing brain vessel disease. Understanding these differences between stroke locations and underlying causes may help doctors better predict which patients are at risk for thinking and memory problems after ICH, particularly in East Asian populations who experience this type of stroke more frequently than Western populations.
Tsai C, Tang S, Wang Y, Chen C, Rannikmäe K, Yip P, et al.. (2026). Clinical and neuroimaging features, and associations with early post-stroke cognition in patients with intracerebral hemorrhage in Taiwan.. PloS one. https://doi.org/10.1371/journal.pone.0358545