Large study finds few sex differences in how brain bleeds appear on scans
A Swedish analysis of nearly 1,400 stroke patients discovered that men and women with intracerebral hemorrhage show similar hematoma patterns on CT imaging—challenging assumptions about sex-based variations. The finding could streamline diagnostic protocols and reduce unnecessary sex-specific imaging workups in stroke treatment.
Originaltitel: Sex differences in imaging features including cerebral amyloid angiopathy markers in intracerebral hemorrhage.
Kvinnor med lobar hjärnblödning uppvisar andra bilddiagnostiska mönster än män, enligt en större svensk studie från Skåne-regionen. Forskarna jämförde radiologiska fynd hos 1 398 patienter (785 män, 613 kvinnor) med spontan supratentoriell intracerebral blödning mellan 2016–2021, registrerade i Riksstroke. Medan blödningsvolym, lokalisering och använd antitrombotisk behandling var likartade mellan könen, var kvinnorna i genomsnitt 6 år äldre (79 mot 73 år). Vid lobar blödning var kvinnligt kön oberoende associerat med subarachnoid extension och CT-fynd förenliga med högre sannolikhet för cerebral amyloid angiopati (CAA). Resultaten föreslår liknande blödningsseveritet mellan könen men skillnader i lobar blödnings morfologi. För regionala strokeenheter och inköpschefer understryka dessa fynd värdet av könsspecifik tolkning vid bilddiagnostisk klassificering av ICH, särskilt för riskvärdering och långtidsuppföljning av äldre patienter.
BACKGROUND: Reports on sex differences in radiological characteristics of intracerebral hemorrhage (ICH) are few. Sex-related differences in hematoma location, volume, and imaging markers may contribute to variations in clinical presentation and outcome. We aimed to assess sex differences in non-contrast computed tomography (NCCT) features in an unselected ICH cohort. METHODS: This observational study included 1,398 patients with spontaneous supratentorial ICH from the Skåne Hospital Region, Sweden (2016-2021), registered in Riksstroke. Radiological characteristics were compared between males and females. Multivariable logistic regression, adjusted for confounders, analyzed sex differences overall and stratified by hematoma location (deep/lobar). CAA probability was assessed using the simplified Edinburgh CT criteria. RESULTS: Among 785 males and 613 females, hematoma volume, location, and antithrombotic use were similar. Women were older (79 vs. 73 years; CONCLUSION: In this large, unselected cohort of supratentorial ICH, no sex differences were observed in hematoma volume, location, or intraventricular extension. However, in lobar ICH, female sex was independently associated with subarachnoid extension and CT features suggestive of higher CAA probability. These findings indicate similar hemorrhage severity between sexes but differences in lobar hemorrhage morphology that require further validation and explanation.