Prevalence and clinical predictors of spasticity after intracerebral hemorrhage

Abstract

Abstract Background Spasticity is a common complication of intracerebral hemorrhage (ICH). However, no consensus exists on the relation between spasticity and initial clinical findings after ICH. Methods This retrospective study enrolled adult patients with a history of ICH between January 2012 and October 2020. The modified Ashworth scale was used to assess spasticity. A trained image analyst traced all ICH lesions. Multivariable logistic regression was used to examine the association between ICH lesion sites and spasticity. Results We finally analyzed 304 patients (mean age 54.86 ± 12.93 years; 72.04% men). The incidence of spasticity in patients with ICH was 30.92%. Higher National Institutes of Health stroke scale (NIHSS) scores were associated with an increased predicted probability for spasticity (odds ratio, OR = 1.153 [95% confidence interval, CI 1.093–1.216], p < .001). Logistic regression analysis revealed that lower age, higher NIHSS scores, and drinking were associated with an increased risk of moderate‐to‐severe spasticity (OR = 0.965 [95% CI 0.939–0.992], p = .013; OR = 1.068 [95% CI 1.008–1.130], p = .025; OR = 4.809 [95% CI 1.671–13.840], p = .004, respectively). However, smoking and ICH in the thalamus were associated with a reduced risk of moderate‐to‐severe spasticity (OR = 0.200 [95% CI 0.071–0.563], p = .002; OR = 0.405 [95% CI 0.140–1.174], p = .046, respectively) compared with ICH in the basal ganglia. Conclusions Our results suggest that ICH lesion locations are at least partly associated with post‐stroke spasticity rather than the latter simply being a physiological reaction to ICH itself. The predictors for spasticity after ICH were age, NIHSS scores, past medical history, and ICH lesion sites.

Keywords

• cerebral hemorrhage
• muscle spasticity
• rehabilitation
• stroke