Abstract
Background: Intracerebral hemorrhage has been associated with changes in various weather conditions. The primary aim of this study was to examine the collective influence of temperature, barometric pressure, and dew point temperature on the incidence of primary spontaneous intracerebral hemorrhage (sICH). Methods: Between January 2013 and December 2016, patients with sICH due to hypertension or amyloid angiopathy with a known time of onset were identified prospectively. Meteorological variables 6 hours prior to time of onset were obtained from the National Oceanic Atmospheric Administration via two weather stations. Using a Monte-Carlo simulation, random populations of meteorological conditions in a 6-hour time window during the same years were generated. The actual meteorological conditions 6-hours prior to sICH were compared to those from the randomly generated populations. The false discovery rate method was used to identify significant meteorological variables. Results: Time of onset was identified in 455 of 603 (75.5%) patients. Distribution curves for change in temperature, mean barometric pressure, and change in barometric pressure 6-hours prior to hemorrhage ictus were found to be significantly different from the random populations. (FDR approach P <.05). For a given change in temperature associated with intracerebral hemorrhage, mean barometric pressure was higher (1018 millibar (mb) versus 1016 mb, P =.03). Barometric pressure data was not influenced by variations in temperature. Conclusions: We concluded that barometric pressure primarily influences the incidence of intracerebral hemorrhage. The association described in the literature between temperature and intracerebral hemorrhage is likely confounded by variations in barometric pressure.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 405-411 |
| Number of pages | 7 |
| Journal | Journal of Stroke and Cerebrovascular Diseases |
| Volume | 28 |
| Issue number | 2 |
| DOIs | |
| State | Published - Feb 2019 |
Funding
This study was approved by the Rush University Medical Center (RUMC) Institutional Review Board and Ethics Committee. All patients with sICH were prospectively screened between January 1, 2013 and December 31, 2016. A diagnosis of primary sICH was made by consensus after review of the patient's initial non-contrast computed topography (CT) and/or CT angiogram. Selected patients underwent further diagnostic work-up with MRI/MRA and/or digital subtraction angiography to exclude occult vascular malformations. Primary sICH was defined as either due to hypertension or cerebral amyloid angiopathy using validated criteria. 11 Patients with sICH due to coagulopathy, vascular malformations, trauma, or tumors were excluded for purposes of this study. The date and time of last known normal were prospectively ascertained from each patient via personal interview with either the patient or surrogate decision maker. Only patients with a known date and time of onset were included in the analysis ( n = 455). Data including age and ethnicity were abstracted from the electronic medical record at the time of admission for each patient. Each sICH was classified according to location of the hematoma and probable etiology of the hemorrhage: hypertensive versus cerebral amyloid angiopathy (CAA) related. The location of the hematoma was divided into (1) deep versus lobar and (2) supratentorial versus infratentorial. Possible and probable CAA were identified using the Boston Criteria 11 and combined into one group. Given absence of tissue, no patient met criteria for definite CAA.
Keywords
- Intracerebral hemorrhage
- barometric pressure
- dew point temperature
- temperature
ASJC Scopus subject areas
- Clinical Neurology
- Cardiology and Cardiovascular Medicine
- Rehabilitation
- Surgery