Risk for symptomatic intracerebral hemorrhage after thrombolysis assessed by diffusion-weighted magnetic resonance imaging.
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Risk for symptomatic intracerebral hemorrhage after thrombolysis assessed by diffusion-weighted magnetic resonance imaging. / Singer, Oliver C; Humpich, Marek C; Fiehler, Jens; Albers, Gregory W; Lansberg, Maarten G; Kastrup, Andiras; Rovira, Alex; Liebeskind, David S; Gass, Achim; Rosso, Charlotte; Derex, Laurent; Kim, Jong S; Neumann-Haefelin, Tobias.
in: ANN NEUROL, Jahrgang 63, Nr. 1, 1, 2008, S. 52-60.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Risk for symptomatic intracerebral hemorrhage after thrombolysis assessed by diffusion-weighted magnetic resonance imaging.
AU - Singer, Oliver C
AU - Humpich, Marek C
AU - Fiehler, Jens
AU - Albers, Gregory W
AU - Lansberg, Maarten G
AU - Kastrup, Andiras
AU - Rovira, Alex
AU - Liebeskind, David S
AU - Gass, Achim
AU - Rosso, Charlotte
AU - Derex, Laurent
AU - Kim, Jong S
AU - Neumann-Haefelin, Tobias
PY - 2008
Y1 - 2008
N2 - OBJECTIVE: The risk for symptomatic intracerebral hemorrhage (sICH) associated with thrombolytic treatment has not been evaluated in large studies using diffusion-weighted imaging (DWI). Here, we investigated the relation between pretreatment DWI lesion size and the risk for sICH after thrombolysis. METHODS: In this retrospective multicenter study, prospectively collected data from 645 patients with anterior circulation stroke treated with intravenous or intraarterial thrombolysis within 6 hours (100 ml; n = 56) DWI lesions. RESULTS: In total, 44 (6.8%) patients experienced development of sICH. The sICH rate was significantly different between subgroups: 2.8, 7.8, and 16.1% in patients with small, moderate, and large DWI lesions, respectively (p <0.05). This translates to a 5.8 (2.8)-fold greater sICH risk for patients with large DWI lesions as compared with patients with small (or moderate) DWI lesions. The results were similar in the large subgroup (n = 536) of patients treated with intravenous tissue plasminogen activator. DWI lesion size remained an independent risk factor when including National Institutes of Health Stroke Scale, age, time to thrombolysis, and leukoariosis in a logistic regression analysis. INTERPRETATION: This multicenter study provides estimates of sICH risk in potential candidates for thrombolysis. The sICH risk increases gradually with increasing DWI lesion size, indicating that the potential benefit of therapy needs to be balanced carefully against the risk for sICH, especially in patients with large DWI lesions.
AB - OBJECTIVE: The risk for symptomatic intracerebral hemorrhage (sICH) associated with thrombolytic treatment has not been evaluated in large studies using diffusion-weighted imaging (DWI). Here, we investigated the relation between pretreatment DWI lesion size and the risk for sICH after thrombolysis. METHODS: In this retrospective multicenter study, prospectively collected data from 645 patients with anterior circulation stroke treated with intravenous or intraarterial thrombolysis within 6 hours (100 ml; n = 56) DWI lesions. RESULTS: In total, 44 (6.8%) patients experienced development of sICH. The sICH rate was significantly different between subgroups: 2.8, 7.8, and 16.1% in patients with small, moderate, and large DWI lesions, respectively (p <0.05). This translates to a 5.8 (2.8)-fold greater sICH risk for patients with large DWI lesions as compared with patients with small (or moderate) DWI lesions. The results were similar in the large subgroup (n = 536) of patients treated with intravenous tissue plasminogen activator. DWI lesion size remained an independent risk factor when including National Institutes of Health Stroke Scale, age, time to thrombolysis, and leukoariosis in a logistic regression analysis. INTERPRETATION: This multicenter study provides estimates of sICH risk in potential candidates for thrombolysis. The sICH risk increases gradually with increasing DWI lesion size, indicating that the potential benefit of therapy needs to be balanced carefully against the risk for sICH, especially in patients with large DWI lesions.
M3 - SCORING: Zeitschriftenaufsatz
VL - 63
SP - 52
EP - 60
JO - ANN NEUROL
JF - ANN NEUROL
SN - 0364-5134
IS - 1
M1 - 1
ER -