Abstract W P258: Magnitude of Acute Blood Pressure Decrease Does Not Predict the Presence of Diffusion-Restricted Lesions in Patients With Intracerebral Hemorrhage
Bibliographic record
Abstract
Introduction: Recent studies have shown an association between aggressive blood pressure (BP) reduction in intracerebral hemorrhage (ICH) and the presence of acute ischemic lesions on diffusion-weighted MR imaging (DWI). However, these findings were based on admission or nadir BP measurements. We tested the hypothesis that the magnitude of acute BP decrease is associated with DWI lesions Methods: We conducted a retrospective analysis of 51 ICH patients who underwent MR imaging with DWI sequences. DWI lesion volumes were measured using planimetric methods. Systolic BP (SBP), diastolic (DBP), and MAP were recorded at baseline, 1,2,6,12, and 24h. Weighted average BP was calculated as the area under the curve of BP measures over 24h. High SBP, low SBP, and high MAP load (calculated as the fraction of time spent >180, <150, or >130 mmHg, respectively) were also determined. Results: Median (IQR) time to MRI was 3.0(4.5) days. Seven patients (14%) demonstrated DWI lesions. Mean DWI volume was 0.97±0.62 ml; 50% of lesions were cortical and 60% were ipsilateral to the hematoma. Median hematoma volume (ml) (16.0(45) vs. 10.5(22), p=0.23) and leukoaraoisis volume (1.8(5.5) vs. 5.6(15.9), p=0.25) did not differ between DWI+ and DWI- patients, respectively. Mean baseline SBP was similar in both groups (171±28 vs. 161.9±28), p=0.44). Weighted mean average SBP in DWI+ patients (158.3±7.5 ml) was similar to that in DWI- patients (143.6±20.4, p=0.21) as was the weighted mean average MAP (102.8±4.3 vs. 98.4±16, p=0.12, respectively). The median 24h decrease in SBP in DWI+ (-20.3 (40.1) mmHg) was similar to that in DWI- patients (-12.7(21), p=0.91). Similarly, high SBP load (5.8% vs. 7.4%, p=0.82), low SBP load (22.5% vs. 60.0%, p=0.16) and high MAP load (6.3% vs. 4.2%,p=0.71) did not differ between groups. Treatment with IV antihypertensive agents was similar in DWI+ (28.6%) and DWI- (29.5%) patients (p=1.00). Conclusions: The magnitude of BP decrease, IV treatment and BP load over 24 hours are not predictive of sub-acute ischemic lesion development. These data do not support a hemodynamic mechanism of DWI lesion formation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".