Heavy Alcohol Use Linked to Cerebral Small Vessel Disease in Intracerebral Hemorrhage

THURSDAY, Nov. 6, 2025 (HealthDay News) — For patients with spontaneous, nontraumatic intracerebral hemorrhage (ICH), heavy alcohol use (HAU) is associated with white matter hyperintensities and a hypertensive cerebral small vessel disease (cSVD) pattern, according to a study published online Nov. 5 in Neurology.

Mette Foldager Hindsholm, M.D., from Harvard Medical School in Boston, and colleagues conducted a cross-sectional study to examine how HAU, defined as regular consumption of at least three drinks/day, is associated with acute ICH characteristics and cSVD burden using data from consecutive patients with spontaneous, nontraumatic ICH.

Seven percent of the 1,600 patients met the criteria for HAU. The researchers found that patients with HAU were significantly younger at ICH onset compared with the non-HAU cohort (median, 64 versus 75 years), and they had larger hematoma volume (1.7-fold increase) and increased odds of deep hemorrhage location and intraventricular extension (adjusted odds ratios [aORs], 2.01 and 1.95, respectively). Overall, 1,195 patients had magnetic resonance imaging (MRI); in an analysis of markers of cSVD, independent associations were seen for HAU with severe white matter hyperintensities and a hypertensive cSVD pattern (aORs, 3.04 and 1.82, respectively). No other associations were seen for MRI markers of cSVD with HAU. There were associations seen for HAU with lower platelet counts and higher admission blood pressure (β = −17.73 and 4.81, respectively).

“We now know that heavy drinking leads to larger, earlier brain bleeds,” coauthor M. Edip Gurol, M.D., also from Harvard Medical School, said in a statement. “Minimizing or stopping alcohol use is an important step to lower that risk. Even for people at relatively low brain bleeding risk, limiting alcohol consumption to no more than three drinks per week may be an effective measure to protect against all types of stroke and to preserve both brain and cardiovascular health.”

Several authors disclosed ties to the biopharmaceutical industry.

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