BACKGROUND: It is still controversial whether intravenous (IV) thrombolysis for acute ischemic stroke increases the risk of aneurysmal bleeding. We sought to find the risk for aneurysmal bleeding after IV thrombolysis in ischemic stroke patients with unruptured cerebral aneurysms. METHODS: We retrospectively analyzed consecutive patients with acute ischemic stroke who had received IVT between August 2006 and November 2009. Immediately after IV-tissue plasminogen activator (tPA) therapy (.9 mg/kg), patients underwent CT angiography, MR angiography. After that, all patients underwent follow-up angiography within 36 hours of the initiation of IV thrombolysis. Aneurysm-related hemorrhage was defined as a hemorrhage that was related to the aneurysm site. RESULTS: A total of 201 patients were analyzed, and 8 (4.1%) had unruptured cerebral aneurysms. Of the 8 patients, 4 had aneurysms over 5 mm of the longest diameter. Three patients had intracerebral hemorrhage that developed at the site of infarction, which was unrelated to the aneurysms. CONCLUSION: The results of this study suggest that IV thrombolysis might not increase the risk of aneurysmal bleeding in acute stroke patients with unruptured aneurysm < 10 mm in diameter. Further studies with a larger sample size are needed to confirm our result.
BACKGROUND: It is still controversial whether intravenous (IV) thrombolysis for acute ischemic stroke increases the risk of aneurysmal bleeding. We sought to find the risk for aneurysmal bleeding after IV thrombolysis in ischemic strokepatients with unruptured cerebral aneurysms. METHODS: We retrospectively analyzed consecutive patients with acute ischemic stroke who had received IVT between August 2006 and November 2009. Immediately after IV-tissue plasminogen activator (tPA) therapy (.9 mg/kg), patients underwent CT angiography, MR angiography. After that, all patients underwent follow-up angiography within 36 hours of the initiation of IV thrombolysis. Aneurysm-related hemorrhage was defined as a hemorrhage that was related to the aneurysm site. RESULTS: A total of 201 patients were analyzed, and 8 (4.1%) had unruptured cerebral aneurysms. Of the 8 patients, 4 had aneurysms over 5 mm of the longest diameter. Three patients had intracerebral hemorrhage that developed at the site of infarction, which was unrelated to the aneurysms. CONCLUSION: The results of this study suggest that IV thrombolysis might not increase the risk of aneurysmal bleeding in acute strokepatients with unruptured aneurysm < 10 mm in diameter. Further studies with a larger sample size are needed to confirm our result.
Authors: Felipe De Los Rios; Dawn O Kleindorfer; Amy Guzik; Santiago Ortega-Gutierrez; Navdeep Sangha; Gyanendra Kumar; James C Grotta; Jin-Moo Lee; Brett C Meyer; Lee H Schwamm; Pooja Khatri Journal: J Stroke Cerebrovasc Dis Date: 2014-08-10 Impact factor: 2.136
Authors: Nitin Goyal; Georgios Tsivgoulis; Ramin Zand; Vijay K Sharma; Kristian Barlinn; Shailesh Male; Aristeidis H Katsanos; Ulf Bodechtel; Sulaiman Iftikhar; Adam Arthur; Lucas Elijovich; Anne W Alexandrov; Andrei V Alexandrov Journal: Neurology Date: 2015-09-25 Impact factor: 9.910
Authors: Diana Briosa E Gala; André Almeida; Nadine Monteiro; Ana Paiva Nunes; Patrícia Ferreira; Nuno Mendonça; Alexandre Amaral-Silva; João Alcântara Journal: Case Rep Neurol Med Date: 2014-11-24