Higher Cerebral Small Vessel Disease Burden is Associated with Smaller Hematoma Volume in Mixed‐Location Intracerebral Hemorrhage

OBJECTIVE To study the relationship between cerebral small vessel disease (CSVD) and hematoma volume in mixed-location intracerebral hemorrhage (ICH), and non-mixed ICH (hypertensive arteriopathy/cerebral amyloid angiopathy-related ICH). METHODS We consecutively collected patients with primary ICH with MRI. Mixed-location ICH was defined as having ICH or cerebral microbleeds (CMBs) in both lobar and deep regions. CSVD markers including lacunes, white matter hyperintensities (WMH), CMBs and enlarged perivascular spaces (EPVS) were assessed on brain MRI during hospitalization. Multivariable binary logistic regression (≥30ml versus 20 in basal ganglia and/or centrum semiovale; β=-0.256, p=0.002 for CSVD score). While These relationships were not observed in non-mixed ICH. CONCLUSIONS Higher CSVD burden is associated with smaller hematoma volume in mixed-location ICH, but not in non-mixed ICH, which is novel and needs further studies with larger sample size to confirm our results and explore the underlying mechanisms.