Cerebral Microbleeds and Risk of Intracerebral Hemorrhage Post Intravenous Thrombolysis.
Background: Stroke patients who have cerebral micro bleeds (CMBs) could be potentially at a greater risk for symptomatic intracerebral hemorrhage (sICH) than those patients without CMBs. The aim of our study was to investigate whether the presence and burden of CMBs are associated with post IVT sICH...
| Published in: | Journal of Stroke & Cerebrovascular Diseases Vol. 26; no. 3; pp. 538 - 545 |
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| Main Authors: | , , , , , , , , , , , |
| Format: | research Journal Article |
| Published: |
W B Saunders
Mar2017
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=121259676&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 121259676 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10523057 DOU jtl: Journal of Stroke & Cerebrovascular Diseases issn: 10523057 maglogo: N pubinfo: dt: Mar2017 vid: 26 iid: 3 pid: 1351 pub: W B Saunders place: Philadelphia, Pennsylvania artinfo: ui: 121259676 121259676 NLM28065404 121259676 10.1016/j.jstrokecerebrovasdis.2016.11.127 NLM28065404 121259676 ppf: 538 ppct: 7 formats: tig: atl: Cerebral Microbleeds and Risk of Intracerebral Hemorrhage Post Intravenous Thrombolysis. aug: au: Zand, Ramin Tsivgoulis, Georgios Singh, Mantinderpreet McCormack, Michael Goyal, Nitin Ishfaq, Muhammad Fawad Shahripour, Reza Bavarsad Nearing, Katherine Elijovich, Lucas Alexandrov, Anne W. Liebeskind, David S. Alexandrov, Andrei V. affil: Department of Neurology, University of Tennessee Health Science Center, Memphis, Tennessee sug: subj: Fibrinolytic Agents Adverse Effects Tissue Plasminogen Activator Adverse Effects Cerebral Hemorrhage Chemically Induced Aged, 80 and Over Administration, Intravenous Adverse Effects Human Stroke Drug Therapy Prospective Studies Aged Middle Age Cerebral Hemorrhage Magnetic Resonance Imaging Female Male Equipment and Supplies Adult Validation Studies Comparative Studies Evaluation Research Multicenter Studies NIH Stroke Scale Scales Aged, 80 & over Aged: 65+ years Middle Aged: 45-64 years Adult: 19-44 years Female Male ab: Background: Stroke patients who have cerebral micro bleeds (CMBs) could be potentially at a greater risk for symptomatic intracerebral hemorrhage (sICH) than those patients without CMBs. The aim of our study was to investigate whether the presence and burden of CMBs are associated with post IVT sICH.Methods: In this multicenter study, consecutive patients treated with intravenous tissue plasminogen activator were prospectively identified and analyzed. Patients without magnetic resonance imaging (MRI) within 24 hours of treatment were excluded. CMBs were defined as round or oval, hypointense lesions with associated blooming on T2*-weighted MRI up to 10 mm in diameter. Outcome measures included the occurrence of sICH or death.Results: Of 672 patients with IVT (mean age 62 ± 14 years, 52% men, median admission NIHSS: 7 points), 103 patients had CMBs on T2*-MRI. Ten patients had more than 10, whereas the remaining 93 patients had 1-10 CMBs on T2*-MRI. The rates of sICH did not differ between patients with and patients without 1-10 CMBs (5.8% versus 3.5%; P = .27). However, sICH occurred more frequently (P = .0009) in patients with > 10 CMBs (30%, 95% confidence interval [CI] by the adjusted Wald method: 10%-61%). After adjusting for potential confounders, the presence of >10 CMBs on T2*-MRI was independently (P = .0004) associated with a higher likelihood for sICH (odds ratio [OR]:13.4, 95%CI:3.2-55.9).Conclusions: Our findings indicate an increased risk of sICH after IVT when more than 10 CMBs are present. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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