Contralateral brain atrophy in conservatively treated primary intracerebral hemorrhage

Abstract Background In patients with intracerebral hemorrhage (ICH), brain volume loss can occur in the hemisphere ipsilateral to the hematoma. However, contralateral hemispheric volume change after ICH is not well known. The present study aimed to investigate contralateral brain volume changes in patients with ICH who had not undergone surgery. Methods Of the 2213 patients with ICH admitted to our hospital between January 2010 and December 2017, 46 patients without surgical intervention were included in the present study. We measured contralateral hemispheric brain volume in the axial images of brain computed tomography (CT) at the time of ICH onset and after 12 months. We analyzed the relationship between various factors and volume changes in the contralateral hemisphere. Results The mean change percentage between the initial and follow-up contralateral parenchyma volume was 96.84%. The average volume decreased by 3.16% (P = 0.001). Univariate and multivariate logistic regression models revealed no significant factors associated with contralateral brain volume loss. Kruskal–Wallis test and Mann–Whitney U test showed no statistical significance (P-value = 0.824, P-value = 0.122) between ICH volume groups. Conclusions Contralateral parenchymal volumes were significantly decreased at follow-up brain CT scanning; these changes may provide important clinical information on the remote effect of focal lesion and symptoms in the course of ICH treatment. However, further investigation is required to determine the mechanisms underlying these volume changes.