BACKGROUND AND PURPOSE: The aim of the study was to evaluate whether leukoaraiosis (LA) is a risk factor for symptomatic intracerebral hemorrhage (sICH) in patients treated with thrombolysis for acute stroke. METHODS: In this retrospective, multicenter analysis, we evaluated data from acute anterior circulation stroke patients (n=449; <6 hours after symptom onset) treated with thrombolysis. All patients had received standard magnetic resonance imaging evaluation before thrombolysis, including a high-quality T2-weighted sequence. For the analysis, LA in the deep white matter was dichotomized into absent or mild versus moderate or severe (corresponding to Fazekas scores of 0 to 1 versus 2 to 3). RESULTS: The rate of sICH was significantly more frequent in patients with moderate to severe LA of the deep white matter (n=12 of 114; 10.5%) than in patients without relevant LA (n=13 of 335; 3.8%), corresponding to an odds ratio of 2.9 (95% CI, 1.29 to 6.59; P=0.015). In a logistic-regression analysis (including age, National Institutes of Health Stroke Scale score at presentation, and type of thrombolytic treatment), LA remained a significant independent risk factor (odds ratio, 2.9; P=0.03). CONCLUSIONS: LA of the deep white matter is an independent risk factor for sICH after thrombolytic treatment for acute stroke.
BACKGROUND AND PURPOSE: The aim of the study was to evaluate whether leukoaraiosis (LA) is a risk factor for symptomatic intracerebral hemorrhage (sICH) in patients treated with thrombolysis for acute stroke. METHODS: In this retrospective, multicenter analysis, we evaluated data from acute anterior circulation strokepatients (n=449; <6 hours after symptom onset) treated with thrombolysis. All patients had received standard magnetic resonance imaging evaluation before thrombolysis, including a high-quality T2-weighted sequence. For the analysis, LA in the deep white matter was dichotomized into absent or mild versus moderate or severe (corresponding to Fazekas scores of 0 to 1 versus 2 to 3). RESULTS: The rate of sICH was significantly more frequent in patients with moderate to severe LA of the deep white matter (n=12 of 114; 10.5%) than in patients without relevant LA (n=13 of 335; 3.8%), corresponding to an odds ratio of 2.9 (95% CI, 1.29 to 6.59; P=0.015). In a logistic-regression analysis (including age, National Institutes of Health Stroke Scale score at presentation, and type of thrombolytic treatment), LA remained a significant independent risk factor (odds ratio, 2.9; P=0.03). CONCLUSIONS: LA of the deep white matter is an independent risk factor for sICH after thrombolytic treatment for acute stroke.
Authors: Michael J Lyerly; J Thomas Houston; Amelia K Boehme; Karen C Albright; Reza Bavarsad Shahripour; Paola Palazzo; Muhammed Alvi; Pawan V Rawal; Niren Kapoor; April Sisson; Anne W Alexandrov; Andrei V Alexandrov Journal: J Stroke Cerebrovasc Dis Date: 2014-03-28 Impact factor: 2.136
Authors: Fabien Scalzo; Jeffry R Alger; Xiao Hu; Jeffrey L Saver; Krishna A Dani; Keith W Muir; Andrew M Demchuk; Shelagh B Coutts; Marie Luby; Steven Warach; David S Liebeskind Journal: Magn Reson Imaging Date: 2013-04-13 Impact factor: 2.546
Authors: Andrew M Demchuk; Firosh Khan; Michael D Hill; Philip A Barber; Brian Silver; Suresh Patel; Steven R Levine Journal: Cerebrovasc Dis Date: 2008-06-17 Impact factor: 2.762
Authors: Hyung-Min Kwon; Michael J Lynn; Tanya N Turan; Colin P Derdeyn; David Fiorella; Bethany F Lane; Jean Montgomery; L Scott Janis; Zoran Rumboldt; Marc I Chimowitz Journal: JAMA Neurol Date: 2016-01 Impact factor: 18.302