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10.1161/STROKEAHA.114.005249

http://scihub22266oqcxt.onion/10.1161/STROKEAHA.114.005249
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suck abstract from ncbi


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pmid24876245
      Stroke 2014 ; 45 (7 ): 2030-5
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  • Pretreatment blood-brain barrier damage and post-treatment intracranial hemorrhage in patients receiving intravenous tissue-type plasminogen activator #MMPMID24876245
  • Leigh R ; Jen SS ; Hillis AE ; Krakauer JW ; Barker PB
  • Stroke 2014[Jul]; 45 (7 ): 2030-5 PMID24876245 show ga
  • BACKGROUND AND PURPOSE: Early blood-brain barrier damage after acute ischemic stroke has previously been qualitatively linked to subsequent intracranial hemorrhage (ICH). In this quantitative study, it was investigated whether the amount of blood-brain barrier damage evident on pre-tissue-type plasminogen activator MRI scans was related to the degree of post-tissue-type plasminogen activator ICH in patients with acute ischemic stroke. METHODS: Analysis was performed on a database of patients with acute ischemic stroke provided by the Stroke Imaging Repository (STIR) and Virtual International Stroke Trials Archive (VISTA) Imaging Investigators. Patients with perfusion-weighted imaging lesions>10 mL and negative gradient-recalled echo imaging before intravenous tissue-type plasminogen activator were included. Postprocessing of the perfusion-weighted imaging source images was performed to estimate changes in blood-brain barrier permeability within the perfusion deficit relative to the unaffected hemisphere. Follow-up gradient-recalled echo images were reviewed for evidence of ICH and divided into 3 groups according to European Cooperative Acute Stroke Study (ECASS) criteria: no hemorrhage, hemorrhagic infarction, and parenchymal hematoma. RESULTS: Seventy-five patients from the database met the inclusion criteria, 28 of whom experienced ICH, of which 19 were classified as hemorrhagic infarction and 9 were classified as parenchymal hematoma. The mean permeability (±SDs), expressed as an index of contrast leakage, was 17.0±8.8% in the no hemorrhage group, 19.4±4.0% in the hemorrhagic infarction group, and 24.6±4.5% in the parenchymal hematoma group. Permeability was significantly correlated with ICH grade in univariate (P=0.007) and multivariate (P=0.008) linear regression modeling. CONCLUSIONS: A perfusion-weighted imaging-derived index of blood-brain barrier damage measured before intravenous tissue-type plasminogen activator is given is associated with the severity of ICH after treatment in patients with acute ischemic stroke.
  • |Aged [MESH]
  • |Aged, 80 and over [MESH]
  • |Blood-Brain Barrier/pathology/*physiopathology [MESH]
  • |Brain Ischemia/*drug therapy/pathology/physiopathology [MESH]
  • |Capillary Permeability/drug effects/*physiology [MESH]
  • |Cerebral Infarction/etiology/pathology/physiopathology [MESH]
  • |Databases, Factual [MESH]
  • |Fibrinolytic Agents/*adverse effects [MESH]
  • |Follow-Up Studies [MESH]
  • |Humans [MESH]
  • |Intracranial Hemorrhages/*etiology/pathology/physiopathology [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Severity of Illness Index [MESH]
  • |Stroke/*drug therapy/pathology/physiopathology [MESH]
  • |Thrombolytic Therapy/*adverse effects [MESH]
  • |Tissue Plasminogen Activator/administration & dosage/*adverse effects [MESH]


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