Imaging of non-traumatic intracerebral and intraventricular haemorrhage Charlotte van Asch Cover Image Enso with pine tree branch Cover Design Hans Scheffers, creationstation.nl Layout Maroesja Swart-Nijhuis, Puur*M Vorm & Idee Printed by Off Page ISBN 978-94-6182-626-8 © 2015 C.J.J. van Asch All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronically, mechanically, by photocopying, recording or otherwise, without the prior written permission of the author. The copyright of the articles that have been published, has been transferred to the respective journals. Imaging of non-traumatic intracerebral and intraventricular haemorrhage Beeldvormend onderzoek van niet-traumatische intracerebrale en intraventriculaire bloedingen (met een samenvatting in het Nederlands) Proefschrift ter verkrijging van de graad van doctor aan de Universiteit Utrecht op gezag van de rector magnificus, prof.dr. G.J. van der Zwaan, ingevolge het besluit van het college voor promoties in het openbaar te verdedigen op donderdag 17 december 2015 des ochtends te 10.30 uur door Charlotte Judith Johanna van Asch geboren op 16 maart 1980 te ’s-Hertogenbosch Promotoren: Prof.dr. G.J.E. Rinkel Prof.dr. C.J.M. Klijn Co-promotor: Dr. B.K. Velthuis The research described in this thesis was supported by a grant of the Dutch Heart Foundation (DHF-2007B048). Financial support by the Dutch Heart Foundation for the publication of this thesis is gratefully acknowledged. Publication of this thesis was also financially supported by Chipsoft BV, Sectra Benelux, UMC Utrecht Brain Center Rudolf Magnus, and ABN AMRO. “Rabbit’s clever,” said Pooh thoughtfully. “Yes,” said Piglet, “Rabbit’s clever.” “And he has Brain.” “Yes,” said Piglet, “Rabbit has Brain.” There was a long silence. “I suppose,” said Pooh, “that that’s why he never understands anything.”  A.A. Milne, The House at Pooh Corner CONTENTS List of abbreviations 9 Chapter 1 General introduction 11 PART I: Epidemiology of intracerebral haemorrhage Chapter 2 Incidence, case fatality, and functional outcome of intracerebral haemorrhage 21 over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis PART II: Imaging of intracerebral and intraventricular haemorrhage Chapter 3 Early intracerebral haematoma expansion after aneurysmal rupture 49 Chapter 4 External validation of the Secondary IntraCerebral Hemorrhage (SICH) score 61 Chapter 5 Diagnostic yield and accuracy of CT angiography, MR angiography and digital 73 subtraction angiography for detection of macrovascular causes of intracerebral haemorrhage – a prospective, multicentre cohort study Chapter 6 The optimal diagnostic strategy for non-traumatic intracerebral 99 haemorrhage: a cost-effectiveness analysis Chapter 7 Yield of angiographic examinations in isolated intraventricular haemorrhage: 129 a case series and systematic review of literature Chapter 8 General discussion 143 Chapter 9 Summary 159 Samenvatting (Dutch summary) 163 Acknowledgements 171 Dankwoord (Personal Acknowledgements) 175 Curriculum Vitae 183 List of publications 185 8 9 LIST OF ABBREVIATIONS AVM arteriovenous malformation CT computed tomography DAVF dural arteriovenous fistula DSA digital subtraction angiography DVA developmental venous anomaly ICH intracerebral haemorrhage IVH intraventricular haemorrhage MRA magnetic resonance angiography MRI magnetic resonance imaging mRS modified Rankin Scale NCCT non-contrast computed tomography SAH subarachnoid haemorrhage QALY quality-adjusted life year 10