Genetics of Cerebral Hemorrhage with Anticoagulation (GOCHA)

This is a prospective, longitudinal cohort study of spontaneous ICH. Subjects were recruited from among consecutive patients ≥ 55 years old who presented with primary hemorrhage to the Massachusetts General Hospital or one of our off-site collaborators from 1999 to 2010. Potential subjects were identified by screening lists of all admissions to the neurology and neurosurgery inpatient services. All patients underwent routine clinical evaluation, including history taking and physical examination, laboratory testing, and computed tomography of the brain.

• Study Design:
  • Case-Control
• Study Type:
  • Case-Control
  • Longitudinal
  • Cohort
• dbGaP estimated ancestry using GRAF-pop
• Total number of consented subjects: 3569
• Subject Sample Telemetry Report (SSTR)

• BioProject
• PubMed
• Sequence Read Archive
• BioSample
• MeSH
• PMC

CASE Inclusion Criteria

1. Symptomatic ICH, sufficiently severe to cause the patient to seek medical attention
2. Age >55, either gender. There is no upper age limit to participation.
3. Ability and willingness of patient, family member, or legal guardian to provide informed consent

CASE Exclusion Criteria

1. If taking warfarin, initial INR at presentation <1.4
2. 2. Concussive head trauma during the 24 hours before ICH presentation (unless trauma was clearly a result of the ICH, e.g. head trauma resulting from a seizure caused by acute ICH)
3. Clinical, radiographic or pathological demonstration of any of the following
1. Ischemic stroke, occurring during the 2 weeks prior to ICH presentation
2. Primary or metastatic intracerebral tumor
3. Intracerebral vascular malformation
4. Vasculitis of the central nervous system
4. Antecedent use of cocaine or sympathomimetic drug
5. Antecedent alcohol abuse (defined as >8 drinks in the previous 24 hours or >28 drinks over the previous week)
6. History of a primary coagulopathy, blood dyscrasia, or active liver disorder
7. Greater than 1 week interval between onset of symptoms and presentation to enrolling center

CONTROL Inclusion Criteria

As above for cases, with the exception that subjects will not have had symptomatic ICH.

CONTROL Exclusion Criteria

1. History of symptomatic ICH
2. If taking Warfarin, initial INR at presentation <1.4
3. Antecedent use of cocaine or sympathomimetic drug
4. Antecedent alcohol abuse (defined as >8 drinks in the previous 24 hours or >28 drinks over the previous week)
5. History of a primary coagulopathy, blood dyscrasia, or active liver disorder

• Primary Phenotype: Intracranial Hemorrhage
• Angiopathy, Cerebral Amyloid
• Amyloid Angiopathy, Cerebral
• Sporadic Cerebral Amyloid Angiopathy
• Hemorrhage, Hypertensive Intracranial
• Hypertensive Intracranial Hemorrhages

• Principal Investigator
  • Jonathan Rosand, MD, MSc. Massachusetts General Hospital, Boston, MA, USA.
• Co-Investigators
  • Steven M. Greenberg, MD, PhD. Massachusetts General Hospital, Boston, MA, USA.
  • James F. Meschia, MD. Mayo Clinic, Jacksonville, FL, USA.
  • Bradford B. Worrall, MD, MSc. University of Virginia Health System, Charlottesville, VA, USA.
  • Scott L. Silliman, MD. University of Florida College of Medicine, Jacksonville, FL, USA.
  • Devon Brown, MD. University of Michigan Health System, Lansing, MI, USA.
  • Magdy H. Selim, MD, PhD. Beth Israel Deaconess Medical Center, Boston, MA, USA.
• Funding Sources
  • R01NS059727. National Institutes of Health, Bethesda, MD, USA.
  • R01NS042147. National Institutes of Health, Bethesda, MD, USA.