Severe cerebral hypovolemia on perfusion CT and lower body weight are associated with parenchymal haemorrhage after thrombolysis.

Détails

ID Serval
serval:BIB_F5CF8878CEAA
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Severe cerebral hypovolemia on perfusion CT and lower body weight are associated with parenchymal haemorrhage after thrombolysis.
Périodique
Neuroradiology
Auteur(s)
Tsetsou S., Amiguet M., Eskandari A., Meuli R., Maeder P., Jiang B., Wintermark M., Michel P.
ISSN
1432-1920 (Electronic)
ISSN-L
0028-3940
Statut éditorial
Publié
Date de publication
01/2017
Peer-reviewed
Oui
Volume
59
Numéro
1
Pages
23-29
Langue
anglais
Notes
Publication types: Journal Article ; Observational Study
Publication Status: ppublish
Résumé
Haemorrhagic transformation of acute ischemic stroke (AIS) and particularly parenchymal haemorrhage (PH) remains a feared complication of intravenous thrombolysis (IVT). We aimed to identify clinical and perfusion CT (PCT) variables which are independently associated with PHs.
In this observational cohort study, based on the Acute Stroke Registry Analysis of Lausanne (ASTRAL) from 2003 to December 2013, we selected patients with AIS involving the middle cerebral artery (MCA) territory who were thrombolysed within 4.5 h of symptoms' onset and who had a good quality baseline PCT at the beginning of IVT. In addition to demographic, clinical, laboratory and non-contrast CT data, volumes of salvageable tissue and ischemic core on PCT, as well as absolute CBF and CBV values within the ischemic regions were compared in patients with and without PH in multivariate analysis.
Of the 190 included patients, 24 (12.6%) presented a PH (11 had PH1 and 13 had PH2). In multivariate analysis of the clinical and radiological variables, the lowest CBV in the core and lower body weight was both significantly associated with PH (p = 0.009 and p = 0.024, respectively).
In thrombolysed MCA strokes, maximal hypoperfusion severity depicted by lowest CBV values in the core region and lower body weight are independently correlated with PH. This information, if confirmed in other case series, may add to the stratification of revascularisation decisions in patients with a perceived high PH risk.
Mots-clé
Aged, Body Weight, Cerebral Angiography/methods, Cerebral Hemorrhage/chemically induced, Cerebral Hemorrhage/diagnostic imaging, Cerebrovascular Circulation, Contrast Media, Female, Humans, Hypovolemia/chemically induced, Hypovolemia/diagnostic imaging, Iohexol, Magnetic Resonance Angiography, Male, Registries, Risk Factors, Stroke/drug therapy, Thrombolytic Therapy/adverse effects, Tomography, X-Ray Computed/methods, Ultrasonography, Doppler, Transcranial, Parenchymal haemorrhage, Perfusion CT, Stroke
Pubmed
Web of science
Création de la notice
03/01/2017 18:08
Dernière modification de la notice
20/08/2019 16:22
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