Abstract WMP104: Sub-Acute Diffusion-Weighted MRI Lesions in Acute Intracerebral Hemorrhage Patients are Unrelated to Blood Pressure
Bibliographic record
Abstract
Introduction: Diffusion-Weighted magnetic resonance imaging (DWI) studies have demonstrated sub-acute ischemic lesions in up to 41% of patients with intracerebral hemorrhage (ICH). Retrospective studies indicated an association with acute blood pressure (BP) reduction. We conducted a prospective study of DWI lesion incidence in ICH patients. Methods: Patients with computed tomography (CT) scan confirmed ICH were prospectively recruited within 6 hours of symptom onset. Acute systolic BP (SBP) targets were randomly assigned as part of an ongoing trial. The SBP target remained blinded for this analysis. Patients were assessed with serial DWI at 48 hours. Results: Eighty-three patients (48.2% male, mean±SD age 71.9±13.4) were enrolled. MRI was obtained in 42 patients. (11 patients were medically unstable, 11 refused consent, 19 died or were treated palliatively prior to the first MRI). Median (IQR) acute hematoma volume of the patients undergoing magnetic resonance imaging was 14.11 (4.40, 38.06) ml. Median baseline NIHSS score was 12.50 (9, 20). Median (IQR) 48 hour hematoma volume was 23.30 (9.10, 65.30) ml. DWI lesions were present in 13 (31%) of patients at 48 hours (median time to scan 54.22 (39.83, 65.5) hours). Mean SBP at 48 hours in patients with lesions (154.55±27.02 mmHg) was similar to those without (149.04±27.02; p = 0.514). Systolic BP at the time of the MRI was not a predictor of ischemic lesion development at 48 hours (OR=1.015, [0.972, 1.059], p =0.507), nor was the change in BP between baseline and the scan (OR=0.994, [0.962, 1.027], p =0.716). The only predictor of 48 hour DWI incidence was hematoma volume at 48 hours (OR= 1.025, 95% CI [1.001, 1.050], p =0.044). Discussion: When enrolled prospectively within 6 hours of onset, DWI was obtained in approximately half of all ICH patients. This selection bias may be relevant to the results of both retrospective and prospective DWI studies. This study demonstrated no evidence of a relationship between actual BP achieved and DWI incidence after ICH.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 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".