• Guofang Chen, Hisatomi Arima, Guojun Wu, Emma Heeley, Candice Delcourt, Peiying Zhang, Alejandro A Rabinstein, Thompson Robinson, Christian Stapf, Yining Huang, Lili Song, Jie Yang, Xia Wang, Qiang Li, Xiaoying Chen, John Chalmers, Craig Anderson, and INTERACT2 Investigators.
• From the Department of Neurology (G.C.) and Department of Cardiology (P.Z.), Xuzhou Central Hospital, Jiangsu, China; The George Institute for Global Health, University of Sydney, Sydney, Australia (G.C., H.A., G.W., E.H., C.D., L.S., J.Y., X.W., Q.L., X.C., J.C., C.A.); Department of Neurology, Hebei Yutian Hospital, Tang Shan, China (G.W.); Department of Neurology, Mayo Clinic, Rochester, MN (A.A.R.); Department of Cardiovascular Sciences and NIHR Biomedical Research Unit for Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom (T.R.); Department of Neurology, Université Paris Diderot-Sorbonne Paris Cité, Paris, France (C.S.); Department of Neurology, Peking University First Hospital, Beijing, China (Y.H.); Department of Neurology, Shanghai 85th Hospital of PLA, Shanghai, China (L.S.); and Department of Neurology, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing, China (J.Y.).
• Stroke. 2014 Jan 1;45(1):258-60.

Background And PurposeThe prognostic significance of subarachnoid extension of intracerebral hemorrhage was determined in the INTEnsive blood pressure Reduction in Acute Cerebral hemorrhage Trial (INTERACT2) study.MethodsINTERACT2 was an open randomized controlled trial of early intensive compared with guideline-recommended blood pressure lowering in patients with elevated systolic blood pressure within 6 hours of intracerebral hemorrhage. Independent predictors of death or major disability (scores 3-6 on the modified Rankin Scale) at 90 days were analyzed in logistic regression models.ResultsOf 2582 participants, 192 (7%) had subarachnoid extension, which was associated with larger hematoma volumes (P<0.0001) and higher National Institute of Health Stroke Scale score (P<0.0001). Subarachnoid extension predicted death or major disability at 90 days (71% versus 53%; unadjusted odds ratio, 2.25; 95% confidence interval, 1.63-3.10; P<0.0001). The association remained significant after adjusting for age, region, lipid-lowering therapy, systolic blood pressure, glucose, location of hematoma, intraventricular extension, and randomized treatment (odds ratio, 2.17; 95% confidence interval, 1.50-3.14; P<0.0001), but not after further adjustment for baseline hematoma volume (P=0.62).ConclusionsSubarachnoid extension of intracerebral hemorrhage is associated with poor prognosis, which is determined by a larger volume of the underlying intraparenchymal hematoma.Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT00716079.

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