{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:46:55Z","timestamp":1791229615084,"version":"4.1.0"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:00:00Z","timestamp":1668556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["P50 AG005134, R01 AG047975, R01 NS104130"],"award-info":[{"award-number":["P50 AG005134, R01 AG047975, R01 NS104130"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Determining the underlying causes of intracerebral hemorrhage (ICH) is of major importance, because risk factors, prognosis, and management differ by ICH subtype. We developed a new causal CLASsification system for ICH Subtypes, termed CLAS\u2010ICH, based on recent advances in neuroimaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>CLAS\u2010ICH defines 5 ICH subtypes: arteriolosclerosis, cerebral amyloid angiopathy, mixed small vessel disease (SVD), other rare forms of SVD (genetic SVD and others), and secondary causes (macrovascular causes, tumor, and other rare causes). Every patient is scored in each category according to the level of diagnostic evidence: (1) well\u2010defined ICH subtype; (2) possible underlying disease; and (0) no evidence of the disease. We evaluated CLAS\u2010ICH in a derivation cohort of 113 patients with ICH from Massachusetts General Hospital, Boston, USA, and in a derivation cohort of 203 patients from Inselspital, Bern, Switzerland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the derivation cohort, a well\u2010defined ICH subtype could be identified in 74 (65.5%) patients, including 24 (21.2%) with arteriolosclerosis, 23 (20.4%) with cerebral amyloid angiopathy, 18 (15.9%) with mixed SVD, and 9 (8.0%) with a secondary cause. One or more possible causes were identified in 42 (37.2%) patients. Interobserver agreement was excellent for each category (kappa value ranging from 0.86 to 1.00). Despite substantial differences in imaging modalities, we obtained similar results in the validation cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>CLAS\u2010ICH is a simple and reliable classification system for ICH subtyping, that captures overlap between causes and the level of diagnostic evidence. CLAS\u2010ICH may guide clinicians to identify ICH causes, and improve ICH classification in multicenter studies. ANN NEUROL 2023;93:16\u201328<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ana.26519","type":"journal-article","created":{"date-parts":[[2022,10,5]],"date-time":"2022-10-05T10:04:10Z","timestamp":1664964250000},"page":"16-28","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":74,"title":["A Causal Classification System for Intracerebral Hemorrhage Subtypes"],"prefix":"10.1002","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9152-4445","authenticated-orcid":false,"given":"Nicolas","family":"Raposo","sequence":"first","affiliation":[{"name":"Department of Neurology Toulouse University Hospital  Toulouse France"},{"name":"Toulouse NeuroImaging Center Toulouse University  Toulouse France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Clara","family":"Zanon Zotin","sequence":"additional","affiliation":[{"name":"Stroke Research Center Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"},{"name":"Center for Imaging Sciences and Medical Physics, Department of Medical Imaging, Hematology and Clinical Oncology, Ribeir\u00e3o Preto Medical School University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3890-3849","authenticated-orcid":false,"given":"David J.","family":"Seiffge","sequence":"additional","affiliation":[{"name":"Department of Neurology, Inselspital Bern University Hospital, University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9144-148X","authenticated-orcid":false,"given":"Qi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology The First Affiliated Hospital of Chongqing Medical University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina B.","family":"Goeldlin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Inselspital Bern University Hospital, University of Bern  Bern Switzerland"},{"name":"Graduate School for Health Sciences University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Charidimou","sequence":"additional","affiliation":[{"name":"Stroke Research Center Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2802-1626","authenticated-orcid":false,"given":"Ashkan","family":"Shoamanesh","sequence":"additional","affiliation":[{"name":"Division of Neurology, Population Health Research Institute McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans Rolf","family":"J\u00e4ger","sequence":"additional","affiliation":[{"name":"Stroke Research Centre, Department of Brain Repair and Rehabilitation UCL Queen Square Institute of Neurology  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Cordonnier","sequence":"additional","affiliation":[{"name":"Univ. 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