ABSTRACT NUMBER: ESOC2026A1125 WALL SHEER STRESS IN THE MEDIAL CEREBRAL ARTERY IS ASSOCIATED WITH OCCURRENCE AND BLEEDING LOCALIZATION IN DEEP, INTRACEREBRAL HAEMORRHAGES

Abstract Background and aims Intracerebral haemorrhage (ICH) is a devastating form of stroke. Various imaging-based markers for hematoma expansion and rebleeding have been described. However, the role of wall sheer stress as a target marker for individualized risk assessment and potential targeted blood pressure therapy is not well investigated. Methods Consecutive patients with deep ICH have been consecutively included in this observational study. 3D-segmentations of all brain supplying arteries, neurovascular ultrasound (nvUS) and physiological data have been used to simulate patient individual flow velocities and wall sheer stress along the medial cerebral artery (MCA). The simulated flow velocities of the intracranial arteries have been compared to the nvUS derived velocities to guarantee accuracy. Results Twenty-five ICH-patients (mean age 68.1±16.5, 75% male) were included. Nineteen (76%) patients bad basal ganglia ICH, remaining patients had a thalamic ICH. Simulated peak systolic velocities (PSV) in the MCA were comparable to nvUS (p>0.2). In the ICH-group, ipsilateral mean WSS in the MCA was higher compared to the corresponding MCA of a control group without ICH (n=53, 36.3 Pa vs. 19.8 Pa, p=0.016; See Fig. 1 and 2). For maximum WSS, simulated values showed a non-statistically significant trend towards higher values in the ipsilateral MCA (150.9 Pa vs. 101.7 Pa, p=0.128). Conclusions WSS of the MCA might represent a target marker for ICH risk, which potentially could be modified by lowering systemic blood pressures. If high WSS in the MCA might also represent a marker for hematoma expansion and re-bleeding is a matter of ongoing analysis. Conflict of interest All authors have nothing to disclose Figure 1 - belongs to Results Figure 2 - belongs to Results