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

TitreSevere cerebral hypovolemia on perfusion CT and lower body weight are associated with parenchymal haemorrhage after thrombolysis.
Publication TypeJournal Article
Year of Publication2017
AuthorsTsetsou, S, Amiguet, M, Eskandari, A, Meuli, R, Maeder, P, Jiang, B, Wintermark, M, Michel, P
Date Published01/2017
ISBN Number1432-1920 (ISSN Electronic) 0028-3940 (linking)
Accession NumberPMID:28028565
Mots-clésAged, Body Weight, Cerebral Angiography/methods, Cerebral Hemorrhage/chemically induced, Cerebral Hemorrhage/diagnostic imaging, Cerebrovascular Circulation, Contrast Media, Doppler, Female, Humans, Hypovolemia/chemically induced, Hypovolemia/diagnostic imaging, Iohexol, Magnetic Resonance Angiography, Male, Parenchymal haemorrhage, Perfusion CT, Registries, Risk Factors, Stroke, Stroke/drug therapy, Thrombolytic Therapy/adverse effects, Tomography, Transcranial, Ultrasonography, X-Ray Computed/methods

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.


Publication types: Journal ArticlePublication Status: aheadofprint Publication Status: ppublish

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Citation Key / SERVAL ID7521
Peer reviewRefereed


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