BACKGROUND AND PURPOSE: Parenchymal hematoma (PH) may worsen the outcome of patients with stroke. The aim of our study was to confirm the relationship between the volume of very low cerebral blood volume (CBV) and PH using a European multicenter database (I-KNOW). A secondary objective was to explore the impact of early reperfusion and recanalization. METHODS: The volume of cerebral tissue with CBV≤2.5th percentile of the normal hemisphere was calculated within the acute diffusion-weighted imaging lesion. Hemorrhagic transformation was assessed on day 2 MRI according to the European Cooperative Acute Stroke Study II criteria. Recanalization and reperfusion were assessed on 3-hour follow-up MRI. RESULTS: Of the 110 patients, hemorrhagic transformation occurred in 59 patients, including 7 PH. In univariate analysis, the acute National Institutes of Health Stroke Scale score (P=0.002), acute diffusion-weighted imaging lesion volume (P=0.02), and thrombolysis (P=0.03), but not very low CBV (P=0.52), were associated with hemorrhagic transformation. The volume of very low CBV was the only predictor of PH (P=0.007). Early reperfusion and recanalization had no influence on either hemorrhagic transformation or PH. CONCLUSION: Very low CBV was the only independent predictor of PH in patients with acute stroke.
BACKGROUND AND PURPOSE: Parenchymal hematoma (PH) may worsen the outcome of patients with stroke. The aim of our study was to confirm the relationship between the volume of very low cerebral blood volume (CBV) and PH using a European multicenter database (I-KNOW). A secondary objective was to explore the impact of early reperfusion and recanalization. METHODS: The volume of cerebral tissue with CBV≤2.5th percentile of the normal hemisphere was calculated within the acute diffusion-weighted imaging lesion. Hemorrhagic transformation was assessed on day 2 MRI according to the European Cooperative Acute Stroke Study II criteria. Recanalization and reperfusion were assessed on 3-hour follow-up MRI. RESULTS: Of the 110 patients, hemorrhagic transformation occurred in 59 patients, including 7 PH. In univariate analysis, the acute National Institutes of Health Stroke Scale score (P=0.002), acute diffusion-weighted imaging lesion volume (P=0.02), and thrombolysis (P=0.03), but not very low CBV (P=0.52), were associated with hemorrhagic transformation. The volume of very low CBV was the only predictor of PH (P=0.007). Early reperfusion and recanalization had no influence on either hemorrhagic transformation or PH. CONCLUSION: Very low CBV was the only independent predictor of PH in patients with acute stroke.
Authors: Wolfgang G Kunz; Wieland H Sommer; Christopher Höhne; Matthias P Fabritius; Felix Schuler; Franziska Dorn; Ahmed E Othman; Felix G Meinel; Louisa von Baumgarten; Maximilian F Reiser; Birgit Ertl-Wagner; Kolja M Thierfelder Journal: J Cereb Blood Flow Metab Date: 2017-01-13 Impact factor: 6.200
Authors: Nishant K Mishra; Søren Christensen; Anke Wouters; Bruce C V Campbell; Matus Straka; Michael Mlynash; Stephanie Kemp; Carlo W Cereda; Roland Bammer; Michael P Marks; Gregory W Albers; Maarten G Lansberg Journal: Stroke Date: 2015-03-31 Impact factor: 7.914
Authors: S Tsetsou; M Amiguet; A Eskandari; R Meuli; P Maeder; B Jiang; M Wintermark; P Michel Journal: Neuroradiology Date: 2016-12-27 Impact factor: 2.804
Authors: Kambiz Nael; James R Knitter; Reza Jahan; Jeffery Gornbein; Zahra Ajani; Lei Feng; Brett C Meyer; Lee H Schwamm; Albert J Yoo; Randolph S Marshall; Philip M Meyers; Dileep R Yavagal; Max Wintermark; David S Liebeskind; Judy Guzy; Sidney Starkman; Jeffrey L Saver; Chelsea S Kidwell Journal: Stroke Date: 2017-01-30 Impact factor: 7.914