The role of leukoaraiosis on outcomes and recombinant tissue-plasminogen activator-related symptomatic intracerebral hemorrhages in acute stroke

Eryildiz E. S., ÖZDEMİR A. Ö., Yilmaz D., Bas D. F.

NEUROLOGICAL SCIENCES AND NEUROPHYSIOLOGY, cilt.37, sa.2, ss.70-74, 2020 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 37 Sayı: 2
  • Basım Tarihi: 2020
  • Doi Numarası: 10.4103/nsn.nsn_11_20
  • Dergi Adı: NEUROLOGICAL SCIENCES AND NEUROPHYSIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.70-74
  • Anahtar Kelimeler: Acute stroke, intracerebral hemorrhage, leukoaraiosis, outcome, thrombolysis, WHITE-MATTER LESIONS, ISCHEMIC-STROKE, CEREBRAL MICROBLEEDS, RISK-FACTOR, THROMBOLYSIS, SUBTYPE, MARKERS, MRI, CT
  • Eskişehir Osmangazi Üniversitesi Adresli: Evet

Özet

Background and Purpose: We aimed to assess whether severe leukoaraiosis (LA) is associated with outcomes and symptomatic intracerebral hemorrhages (sICH) in patients who were treated with recombinant tissue-plasminogen activator (rt-PA) for acute stroke. Methods: We analyzed the data of anterior circulation stroke patients who were treated with rt-PA at our stroke center during 2009-2016. LA was scored according to the van Swieten scale (VSS) on computed tomography (CT) and dichotomized into groups as absent or moderate versus severe LA. We used the safe implementation of thrombolysis in stroke definition for sICH and the modified Rankin Scale (mRS) scores at 3 months after rt-PA were recorded. Results: Of 302 patients, 47 (15.6%) showed severe LA (VSS >4) on CT. The overall sICH rate was 3.6%. Moreover, sICH was significantly more frequent in patients with severe LA (n = 5 of 47; 10.6%) than in patients with absent/moderate LA (n = 6 of 255; 2.4%; P = 0.017). In addition, patients with severe LA had higher baseline glucose level (P = 0.006) and systolic blood pressure (P = 0.005) compared to patients with absent/moderate LA. Patients with severe LA were more likely to have a poor outcome (mRS: 3-6) compared to those without severe LA (P = 0.009). Conclusion: The presence of severe LA on CT increases the risk of sICH and poor outcome in patients treated with rt-PA for acute stroke.