Predisposing Factors, Pathologies, and Precipitating Factors Causing Intracerebral Hemorrhage

作者：Alice Hosking, Neshika Samarasekera, Tom J. Moullaali, William Whiteley, Vega Pratiwi Putri, Mark Rodrigues, Colin Smith, Santosh B. Murthy, David Gaist, Paula Muñoz Venturelli, Xin Cheng, Craig S. Anderson, Ashkan Shoamanesh, Rustam Al‐Shahi Salman · 发表于：Stroke · 年份：2025 · DOI：10.1161/strokeaha.125.051831 · 被引用次数：7 · 研究领域：Intracerebral and Subarachnoid Hemorrhage Research、Acute Ischemic Stroke Management、Intracranial Aneurysms: Treatment and Complications

Most people with spontaneous intracerebral hemorrhage (ICH) have hypertension, which is the strongest modifiable predisposing (risk) factor. However, multiple long-term medical conditions and other known predisposing factors for ICH usually coexist with hypertension, indicating that the causal pathway is multifactorial, and the term hypertensive ICH is oversimplistic. In this review, we integrate the highest quality evidence and our clinical experience in a framework to attribute multiple predisposing factors, underlying pathologies, and precipitating factors as the cause of ICH. In clinical practice, this framework supports physicians to take a holistic approach to treatment and prevention of ICH. In research, this framework shows how existing classification systems for the cause of ICH include underlying macrovascular, microvascular, and other structural pathologies but few predisposing or precipitating factors. Furthermore, this framework can inform the development of a more holistic classification system and expose knowledge gaps, including how predisposing factors lead to underlying pathologies and why only some people with these pathologies experience ICH.