Background and purpose Cortical superficial siderosis (cSS) and cerebral microbleed (CMB) have distinct effects on intracerebral haemorrhage (ICH). We aim to investigate the combined effect of cSS and CMB on outcomes after ICH. Methods Based on a single-centre stroke registry database, patients with spontaneous ICH who had CT scan within 48 hours after ictus and MRI subsequently were identified. Eligible patients were divided into four groups (cSS-CMB−, cSS-CMB+, cSS+CMB−, cSS+CMB+) according to cSS and CMB on susceptibility-weighted image of MRI. Primary outcomes were haematoma volume on admission and unfavourable outcome defined as modified Rankin Scale scores ≥3 at 3 months. Secondary outcomes were all-cause death, recurrence of stroke and ICH during follow-up (median follow-up 2.0 years, IQR 1.0–3.0 years). Results A total of 673 patients were identified from 1044 patients with spontaneous ICH. 131 (19.5%) had cSS and 468 (69.5%) had CMB. Patients with cSS+CMB+ had the highest rate of poor outcome at 3 months, as well as all-cause death, recurrent stroke and ICH during follow-up. In cSS− patients, CMB was associated with smaller haematoma (β −0.13; 95% CI −0.22 to −0.03; p=0.009), but it still increased risks of recurrent ICH (OR 4.6; 95% CI 1.3 to 15.6; p=0.015) and stroke (OR 2.0; 95% CI 1.0 to 4.0; p=0.049). These effects of CMB became unremarkable in the context of cSS+. Conclusions Patients with different combinations of cSS and CMB have distinct patterns of short-term and long-term outcomes. Although CMB is related to restrained haematoma, it does not improve long-term outcomes. Trial registration number [NCT04803292][1]. Data are available on reasonable request. Data are presented within the article and online supplemental materials. Additional information can be obtained on request to the corresponding author. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04803292&atom=%2Fsvnbmj%2Fearly%2F2023%2F11%2F10%2Fsvn-2023-002439.atom

中文翻译：

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皮质浅层铁沉积和脑微出血对脑出血后短期和长期预后的联合影响

背景和目的皮质浅表铁沉积（cSS）和脑微出血（CMB）对脑出血（ICH）有不同的影响。我们的目的是研究 cSS 和 CMB 对 ICH 后结局的综合影响。方法基于单中心脑卒中登记数据库，识别发作后48小时内进行CT扫描并随后进行MRI检查的自发性脑出血患者。根据MRI磁敏感加权图像上的cSS和CMB，将符合条件的患者分为四组（cSS-CMB−、cSS-CMB+、cSS+CMB−、cSS+CMB+）。主要结局是入院时的血肿量和不良结局，定义为 3 个月时改良 Rankin 量表评分≥3。次要结局是随访期间全因死亡、卒中复发和脑出血（中位随访 2.0 年，IQR 1.0-3.0 年）。结果 1044 例自发性脑出血患者中，共鉴定出 673 例患者。131 人 (19.5%) 患有 cSS，468 人 (69.5%) 患有 CMB。cSS+CMB+ 患者 3 个月时不良结局发生率最高，随访期间全因死亡、复发性卒中和 ICH 发生率最高。在 cSS− 患者中，CMB 与较小的血肿相关（β -0.13；95% CI -0.22 至 -0.03；p=0.009），但它仍然增加复发 ICH 的风险（OR 4.6；95% CI 1.3 至 15.6；p =0.015）和中风（OR 2.0；95% CI 1.0 至 4.0；p=0.049）。CMB 的这些影响在 cSS+ 的背景下变得不那么显着。结论 患有不同 cSS 和 CMB 组合的患者具有不同的短期和长期结局模式。尽管 CMB 与限制性血肿有关，但它并不能改善长期结果。试用注册号[NCT04803292][1]。可根据合理要求提供数据。数据在文章和在线补充材料中提供。可以根据相应作者的要求获得更多信息。[1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04803292&atom=%2Fsvnbmj%2Fearly%2F2023%2F11%2F10%2Fsvn-2023-002439.atom