A Novel Score to Predict Risk of Symptomatic Intracerebral Hemorrhage

The Henan-PRIHS was developed from 95 patients who underwent IA-CEFDCT and MT for acute anterior stroke. Patients were classified as having one of three grades according to the presence of contrast filling within the occluded vascular territory. Grade 0 was normal or less contrast filling in affected hemisphere, grade 1 and 2 were small and medium-large area without contrast filling, respectively. The Youden index was used to determine the optimum no contrast filling area cutoff for defining grade 1 and 2. The score was subsequently validated in a different population of 208 patients and compared with three established scores.

Inclusion criteria

• age ≥18 years,
• occlusion of internal carotid artery and/or middle cerebral artery (MCA) M1 or M2 segments confirmed by CTA or MRA or DSA,
• baseline National Institutes of Health Stroke Scale (NIHSS) score ≥ 4 points,
• MT was performed within 16 hours from stroke onset,
• baseline CT scan and IA-CEFDCT scan must be performed; 24 hours post-treatment CT scan was done and when the patient's neurological state had deteriorated.

Exclusion criteria

• bilateral infarcts,
• history of hemorrhagic stroke,
• post-procedure ICH (including SAH) due to iatrogenic complications,
• missing clinical and demographic data,
• poor-quality IA-CEFDCT scans (i.e., motion artifact) that limited accurate identification of the region of interest. Bridge treatment (combined intravenous thrombolysis with MT) was not excluded from this study.