Name:
C.J.J. van Asch
Department of Neurology and Neurosurgery
Section Cerebrovascular Disorders
Function:
MD, PhD-student
E-mail:
c.j.j.vanasch@umcutrecht.nl Tel: +31 88 7558350
Pager: 3751
Supervisor:
prof.dr. G.J.E. Rinkel, dr. C.J.M. Klijn
Title research:
DIagnostic AngioGRAphy to find vascular Malformations in patients with spontaneous intracerebral haemorrhage (DIAGRAM study)
Summary research:
Background.
Spontaneous intracerebral haemorrhage (ICH) accounts for 10-15% of all strokes. ICH may be caused by leakage from small vessels affected by hypertension, by cerebral amyloid angiopathy, in particular in elderly patients, or by bleeding from a vascular malformation. In patients younger than 45 years of age brain arteriovenous malfomation
(AVM) is the most common single cause of ICH. ICH can also be caused by rupture of an aneurysm (without evident subarachnoid haemorrhage), by cavernous angiomas, by venous angiomas, and by dural AVMs.
Except for the specific group of patients older that 45 year of age with ICH in the basal ganglia and a history of hypertension, it is unknown which investigations should be done and when in order to find or exclude a vascular malformation in patients with ICH. CTA, MRI/MRA and DSA, in some cases more than once, are currently performed to detect vascular malformations.
Finding a vascular malformation has important prognostic and therapeutic implications.
Hypothesis:
1. Vascular malformations in patients with spontaneous intracerebral haemorrhage (ICH) can be found or excluded with less diagnostic tests than the combination of the three modalities CTA, MRI/MRA and DSA.
2. The (combination) of test(s) that should be performed in any individual patient can be determined based on patient characteristics (such as age, history of hypertension and clinical condition) and on characteristics of the ICH (such as location and volume).
Publications:
Van Asch CJJ, Luitse MJA, Rinkel GJE, Algra A, Klijn CJM. Incidence and case-fatality of intracerebral haemorrhage. A systematic review of the literature with an emphasis on age, sex, ethnicity and time trend. In preparation.
Van Asch CJJ, van der Schaaf IC, GJE Rinkel. Acute hydrocephalus and cerebral perfusion after aneurysmal subarachnoid haemorrhage. Submitted.
Van Asch CJJ, Balemans WA, Rovers MM, Schilder AG, van der Ent CK. Atopic disease and exhaled nitric oxide in an unselected population of young adults. Ann Allergy Asthma Immunol. 2008;100:59-65.