Observational studyNeurology2024
MRI-Based Prediction of Macrovascular Causes of Intracerebral Hemorrhage: The MACRO Score.
Abstract readObservational Study
In one paragraph
Observational study in Neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed.
- Impact of FXIII Levels on Hematoma Expansion and Outcomes in Patients with Spontaneous Intracranial Hemorrhage: A Prospective Observational Cohort Study of 132 Patients.Neurocritical care · 2026Observational
- Development and validation of the FLATS score to predict periprocedural ischemic events after stent-assisted coiling for ruptured intracranial aneurysms in the acute phase: a nationwide chinese registry.Neurosurgical review · 2026Article
- Sex differences in aetiology of intracerebral haemorrhage and associated small vessel disease patterns.European stroke journal · 2026Observational
- Follow-up imaging after hospital discharge for acute intracerebral hemorrhage in European academic hospitals: a decision-making analysis.Neuroradiology · 2026Article
- Understanding the need and feasibility of a transitional care training program for family caregivers of geriatric stroke survivors.BMC nursing · 2026Article
- Explainable deep learning algorithm for identifying cerebral venous sinus thrombosis-related hemorrhage (CVST-ICH) from spontaneous intracerebral hemorrhage using computed tomography.EClinicalMedicine · 2025Article
- Intracerebral haemorrhage - mechanisms, diagnosis and prospects for treatment and prevention.Nature reviews. Neurology · 2024Review
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Authors and funding
21 authors.
Simon Fandler-HöflerFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0001-9043-0378
Gareth AmblerFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0002-5322-7327
Martina B GoeldlinFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0001-5800-116X
Lena ObergottsbergerFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0009-0001-5583-7647
Gerit WünschFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0009-0007-3076-3390
Markus KneihslFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0002-6334-9432
Wenpeng ZhangFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0001-8748-3962
Yang DuFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0002-0805-6282
Martina LocatelliFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0002-5019-964X
Hatice OzkanFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0003-1656-4559
Philip S NashFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0003-2428-1575
Oliver NistlFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0009-0009-8614-629X
Larysa PanteleienkoFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0002-7342-2488
Rom MendelFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0009-0007-0308-4990
Kitti ThiankhawFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0002-0556-541X
Robert J SimisterFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0003-0578-6711
Hans Rolf JägerFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0002-6403-4184
Christian EnzingerFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0001-9764-7617
David J SeiffgeFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0003-3890-3849
Thomas GattringerFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0002-6065-6576
David J WerringFrom the Department of Neurology (S.F.-H., L.O., M.K., C.E., T.G.), Medical University of Graz, Austria; Department of Statistical Science (G.A.), University College London, United Kingdom; Department of Neurology (M.B.G., D.J.S.), University Hospital Bern, Inselspital, University of Bern, Switzerland; Institute for Medical Informatics, Statistics and Documentation (G.W.), Medical University of Graz, Austria; Stroke Research Centre (S.F.-H., W.Z., Y.D., M.L., H.O., P.S.N., L.P., R.M., K.T., R.J.S., D.J.W.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom; Division of Neuroradiology, Vascular and Interventional Radiology (O.N.), Department of Radiology, Medical University of Graz, Austria; and Neuroradiological Academic Unit (H.R.J.), Department of Brain Repair & Rehabilitation, UCL Queen Square Institute of Neurology, United Kingdom.ORCID 0000-0003-2074-1861
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesAlthough most spontaneous intracerebral hemorrhages (ICHs) are due to cerebral small vessel diseases (SVDs), between 1 in 7 and 1 in 10 are due to a macrovascular cause. Rapid diagnosis has important therapeutic and prognostic implications but sometimes requires digital subtraction angiography (DSA), an invasive procedure which cannot be performed in all patients. MRI provides optimal sensitivity for markers of SVD but was not included in previous risk stratification scores. We aimed to create and validate a risk stratification score for macrovascular causes of ICH including MRI findings to guide diagnosis and further investigations.
methodsWe pooled data from 2 large observational study cohorts (London/United Kingdom and Graz/Austria) of consecutive patients with ICH who had brain MRI and at least 1 angiographic modality within 90 days of symptom onset. The primary outcome was a macrovascular cause of ICH (arteriovenous malformation/dural arteriovenous fistula, aneurysm, cavernoma, or cerebral venous thrombosis), with the diagnosis based on neurovascular multidisciplinary meetings. Using lasso logistic regression, we built the MRI Assessment of the Causes of intRacerebral haemOrrhage (MACRO) score to assess the probability of a macrovascular cause. We performed internal validation using bootstrapping and external validation in an independent cohort (Bern/Switzerland).
resultsWe included 1,043 patients with ICH (mean age 66 years, 42% female), 78 of whom had a macrovascular cause (7.5%). The final score includes age (0-39, 40-69, or ≥70), location of ICH (lobar, deep, or infratentorial), and SVD markers on MRI (≥1 microbleed, ≥1 lacune, presence of cortical superficial siderosis, or white matter hyperintensities using the Fazekas scale). The MACRO score showed an optimism-adjusted DISCUSSION: The MRI-based MACRO score shows excellent performance in predicting the likelihood of macrovascular causes of spontaneous intracerebral hemorrhage, making it useful in guiding further investigations. Important limitations include the observational study design and the performance of DSA in a minority of patients.
Indexed as
Cerebral HemorrhageMagnetic Resonance ImagingAgedAged, 80 and overCohort StudiesFemaleHumansMaleMiddle AgedRisk Assessment
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