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10.1186/s12883-018-1029-0 http://scihub22266oqcxt.onion/10.1186/s12883-018-1029-0 C5870091!5870091 !29587638     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=29587638 &cmd=llinks): Failed to open stream: HTTP request failed! 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Cerebral microbleeds shouldn t dictate treatment of acute stroke: a retrospective cohort study evaluating risk of intracerebral hemorrhage |pdf=|usr=}}{{29587638 }} gab.com Text Cerebral microbleeds shouldn t dictate treatment of acute stroke: a retrospective cohort study evaluating risk of intracerebral hemorrhage JO: BMC Neurol http://www.kidney.de/pget.php?&tw=1&pmid=29587638 #FOAvip BACKGROUND: Intravenous tissue plasminogen activator (IV tPA) after acute ischemic stroke carries the risk of symptomatic intracerebral hemorrhage (sICH). Cerebral microbleeds (CMBs) may indicate increased risk of hemorrhage and can be seen on magnetic resonance imaging (MRI). In this study, we examined the association between CMBs and sICH, focusing on the predictive value of their presence, burden, and location. METHODS: Records from all patients presenting to two academic stroke centers with acute ischemic stroke treated with IV tPA over a 5-year period were retrospectively reviewed. Demographic, medical, and imaging variables were evaluated. The presence, number, and location (lobar vs nonlobar) of CMBs were noted on gradient echo MRI sequences obtained during the admission. Univariable and multivariable statistical models were used to determine the relationship between CMBs and hemorrhagic (symptomatic and asymptomatic) transformation. RESULTS: Of 292 patients (mean age 62.8 years (SD 15.3), 49% African-American, 52% women), 21% (n =?62) had at least one CMB, 1% (n =?3) had >?10 CMBs, and 1% (n?=?3) were diagnosed with probable cerebral amyloid angiopathy. After treatment, 16% (n =?46) developed hemorrhagic transformation, of which 6 (2%) were sICH. There was no association between CMB presence (p =?.135) or location (p =?.325) with sICH; however, those with a high CMB burden (>?10 CMB) were more likely to develop sICH (OR 37.8; 95% CI: 2.7-539.3; p =?.007). CONCLUSIONS: Our findings support prior findings that a high CMB burden (>?10) in patients with acute stroke treated with IV tPA are associated with a higher risk of sICH. However, the overall rate of sICH in the presence of CMB is very low, indicating that the presence of CMBs by itself should not dictate the decision to treat with thrombolytics. Twit Text FOAVip Cerebral microbleeds shouldn t dictate treatment of acute stroke: a retrospective cohort study evaluating risk of intracerebral hemorrhage ????BMC Neurol http://www.kidney.de/pget.php?&tw=1&pmid=29587638 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=29587638 #FOAvip English Wikipedia <ref>{{Cite pmid|29587638 }}</ref> Cerebral microbleeds shouldn t dictate treatment of acute stroke: a retrospective cohort study evaluating risk of intracerebral hemorrhage #MMPMID29587638 Chacon-Portillo MA ; Llinas RH ; Marsh EB BMC Neurol 2018[Mar]; 18 (1 ): 33 PMID29587638 show ga BACKGROUND: Intravenous tissue plasminogen activator (IV tPA) after acute ischemic stroke carries the risk of symptomatic intracerebral hemorrhage (sICH). Cerebral microbleeds (CMBs) may indicate increased risk of hemorrhage and can be seen on magnetic resonance imaging (MRI). In this study, we examined the association between CMBs and sICH, focusing on the predictive value of their presence, burden, and location. METHODS: Records from all patients presenting to two academic stroke centers with acute ischemic stroke treated with IV tPA over a 5-year period were retrospectively reviewed. Demographic, medical, and imaging variables were evaluated. The presence, number, and location (lobar vs nonlobar) of CMBs were noted on gradient echo MRI sequences obtained during the admission. Univariable and multivariable statistical models were used to determine the relationship between CMBs and hemorrhagic (symptomatic and asymptomatic) transformation. RESULTS: Of 292 patients (mean age 62.8 years (SD 15.3), 49% African-American, 52% women), 21% (n =?62) had at least one CMB, 1% (n =?3) had >?10 CMBs, and 1% (n?=?3) were diagnosed with probable cerebral amyloid angiopathy. After treatment, 16% (n =?46) developed hemorrhagic transformation, of which 6 (2%) were sICH. There was no association between CMB presence (p =?.135) or location (p =?.325) with sICH; however, those with a high CMB burden (>?10 CMB) were more likely to develop sICH (OR 37.8; 95% CI: 2.7-539.3; p =?.007). CONCLUSIONS: Our findings support prior findings that a high CMB burden (>?10) in patients with acute stroke treated with IV tPA are associated with a higher risk of sICH. However, the overall rate of sICH in the presence of CMB is very low, indicating that the presence of CMBs by itself should not dictate the decision to treat with thrombolytics. |Administration, Intravenous [MESH] |Aged [MESH] |Black or African American [MESH] |Cerebral Amyloid Angiopathy/complications [MESH] |Cerebral Hemorrhage/*chemically induced/diagnostic imaging [MESH] |Female [MESH] |Fibrinolytic Agents/*adverse effects [MESH] |Hospitalization [MESH] |Humans [MESH] |Magnetic Resonance Imaging [MESH] |Male [MESH] |Middle Aged [MESH] |Models, Statistical [MESH] |Probability [MESH] |Retrospective Studies [MESH] |Risk [MESH] |Stroke/complications/*drug therapy [MESH] |Thrombolytic Therapy/*adverse effects [MESH]Cerebral microbleeds shouldn t dictate treatment of acute stroke: a re(epmc).pdf DeepDyve Pubget Overpricing