Clinical and neuroimaging features, and associations with early post-stroke cognition in patients with intracerebral hemorrhage in Taiwan

Background East Asians have a higher incidence rate of intracerebral hemorrhage (ICH). As clinical and neuroimaging characteristics, genetic and vascular risk factors, and prognosis might vary between populations, we aimed to make comparisons between different ICH locations and etiologies, and to investigate the factors associated with early post-stroke cognition in Chinese patients in Taiwan. Methods We prospectively recruited acute spontaneous Chinese ICH patients from two large Hospitals in Taiwan. For included patients, we compared major vascular risk factors, APOE genotypes, clinical and neuroimaging features, and early post-stroke cognition in patients with lobar versus non-lobar ICH and in cerebral amyloid angiopathy (CAA) versus non-CAA group. Furthermore, we used generalized linear models to investigate the associated factors with early global cognitive performance after ICH. Results In 202 included acute spontaneous ICH patients, 65% were men. 80% were non-lobar ICH, and 20% were lobar ICH. Lobar ICH patients generally had an older age, worse conscious level, a higher 1-month case fatality, a larger ICH volume, more lobar CMBs and cortical superficial siderosis, and worse early post-stroke cognitive function, while non-lobar patients had a higher proportion of hypertension (98% vs 85%, p < 0.001). Similar findings were noted when comparing patients of CAA group with non-CAA groups. Generalized linear regression models revealed that age, education, initial conscious level, stroke severity, ICH volume and lobar CMB burden were associated with early post-stroke cognition in ICH patients. Conclusion Our study demonstrated the differences in clinical and imaging features, major risk factors, and early post-stroke cognitive function between different locations and etiologies in Chinese ICH patients in Taiwan. Age, education, stroke severity, ICH volume and lobar CMB burden were the associated factors for early global cognitive performance after ICH.