Cerebral venous outflow participates in perihematomal edema after spontaneous intracerebral hemorrhage: A cross-sectional study

Cerebrospinal venous anatomy and hemodynamics changes are associated with many central nervous system disorders. The aim of this study was to detect whether perihematomal edema (PHE) after spontaneous intracerebral hemorrhage (sICH) is associated with cerebral venous outflow volume (CVFV) in the internal jugular veins and vertebral veins. Newly diagnosed cases of sICH between April 2016 and March 2017 were enrolled and patients were grouped to the mean value of PHE according to previous study. On computed tomography, absolute PHE volume was calculated as the difference between total lesion volume and intracerebral hemorrhage (ICH) volume. Relative PHE volume was defined as absolute PHE volume divided by ICH volume. CVFV was determined by Doppler ultrasound. Patients were divided according to mean values of absolute PHE at 3 and 12 days, and relative PHE (rPHE) at 3 and 12 days. Significant differences were observed in smoking, alcohol consumption, glycosylated hemoglobin (GHb), secondary intraventricular hemorrhage (sIVH), and CVFV in PHE at 72 hours. Only sIVH and CVFV were significantly different at 12 days in PHE. In rPHE, GHb and sIVH were significantly differed at 72 hours. No significant difference was observed at 12 days in rPHE. The multivariate analyses showed that CVFV was independently associated with late PHE (PHE at 12 ± 3 days) but not with early PHE (PHE at 72 hours) and rPHE. These results suggest that CVFV may be closely related to PHE after sICH.