| Title: |
Microbleeds, Cerebral Hemorrhage, and Functional Outcome After Stroke Thrombolysis ; Individual Patient Data Meta-Analysis |
| Authors: |
Charidimou, Andreas; Turc, Guillaume; Oppenheim, Catherine; Yan, Shenqiang; Scheitz, Jan F.; Erdur, Hebun; Klinger-Gratz, Pascal P.; El-Koussy, Marwan; Takahashi, Wakoh; Moriya, Yusuke; Wilson, Duncan; Kidwell, Chelsea S.; Saver, Jeffrey L.; Sallem, Asma; Moulin, Solene; Edjlali-Goujon, Myriam; Thijs, Vincent; Fox, Zoe; Shoamanesh, Ashkan; Albers, Gregory W.; Mattle, Heinrich P.; Benavente, Oscar R.; Jäger, H. Rolf; Ambler, Gareth; Aoki, Junya; Baron, Jean-Claude; Kimura, Kazumi; Kakuda, Wataru; Takizawa, Shunya; Jung, Simon; Nolte, Christian H.; Lou, Min; Cordonnier, Charlotte; Werring, David J. |
| Source: |
Stroke ; volume 48, issue 8, page 2084-2090 ; ISSN 0039-2499 1524-4628 |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2017 |
| Description: |
Background and Purpose— We assessed whether the presence, number, and distribution of cerebral microbleeds (CMBs) on pre-intravenous thrombolysis MRI scans of acute ischemic stroke patients are associated with an increased risk of intracerebral hemorrhage (ICH) or poor functional outcome. Methods— We performed an individual patient data meta-analysis, including prospective and retrospective studies of acute ischemic stroke treated with intravenous tissue-type plasminogen activator. Using multilevel mixed-effects logistic regression, we investigated associations of pre-treatment CMB presence, burden (1, 2–4, ≥5, and >10), and presumed pathogenesis (cerebral amyloid angiopathy defined as strictly lobar CMBs and noncerebral amyloid angiopathy) with symptomatic ICH, parenchymal hematoma (within [parenchymal hemorrhage, PH] and remote from the ischemic area [remote parenchymal hemorrhage, PHr]), and poor 3- to 6-month functional outcome (modified Rankin score >2). Results— In 1973 patients from 8 centers, the crude prevalence of CMBs was 526 of 1973 (26.7%). A total of 77 of 1973 (3.9%) patients experienced symptomatic ICH, 210 of 1806 (11.6%) experienced PH, and 56 of 1720 (3.3%) experienced PHr. In adjusted analyses, patients with CMBs (compared with those without CMBs) had increased risk of PH (odds ratio: 1.50; 95% confidence interval: 1.09–2.07; P =0.013) and PHr (odds ratio: 3.04; 95% confidence interval: 1.73–5.35; P |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1161/strokeaha.116.012992 |
| DOI: |
10.1161/STROKEAHA.116.012992 |
| Availability: |
https://doi.org/10.1161/strokeaha.116.012992; https://www.ahajournals.org/doi/full/10.1161/STROKEAHA.116.012992 |
| Accession Number: |
edsbas.DD53C033 |
| Database: |
BASE |