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Microbleeds, cerebral hemorrhage, and ...
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Document type :
Article dans une revue scientifique: Article original
DOI :
10.1161/STROKEAHA.116.012992
PMID :
28720659
Permalink :
http://hdl.handle.net/20.500.12210/16592
Title :
Microbleeds, cerebral hemorrhage, and functional outcome after stroke thrombolysis individual patient data meta-analysis
Author(s) :
Charidimou, Andreas [Auteur]
Turc, Guillaume [Auteur]
Oppenheim, Catherine [Auteur]
Yan, Shenqiang [Auteur]
Scheitz, Jan F. [Auteur]
Erdur, Hebun [Auteur]
Klinger-Gratz, Pascal P. [Auteur]
El-Koussy, Marwan [Auteur]
Takahashi, Wakoh [Auteur]
Moriya, Yusuke [Auteur]
Wilson, Duncan [Auteur]
Kidwell, Chelsea S. [Auteur]
Saver, Jeffrey L. [Auteur]
Sallem, Asma [Auteur]
Moulin, Solene [Auteur]
Edjlali-Goujon, Myriam [Auteur]
Thijs, Vincent N. S. [Auteur]
Fox, Zoe [Auteur]
Shoamanesh, Ashkan [Auteur]
Albers, Gregory W. [Auteur]
Mattle, Heinrich P. [Auteur]
Benavente, Oscar R. [Auteur]
Jaeger, H. Rolf [Auteur]
Ambler, Gareth [Auteur]
Aoki, Junya [Auteur]
Baron, Jean-Claude [Auteur]
Kimura, Kazumi [Auteur]
Kakuda, Wataru [Auteur]
Takizawa, Shunya [Auteur]
Jung, Simon [Auteur]
Nolte, Christian H. [Auteur]
Lou, Min [Auteur]
Cordonnier, Charlotte [Auteur] refId
Troubles cognitifs dégénératifs et vasculaires - U 1171 [TCDV]
Troubles cognitifs dégénératifs et vasculaires - U 1171 [TCDV]
Troubles cognitifs dégénératifs et vasculaires - U1171
Werring, David J. [Auteur]
Journal title :
Stroke
Abbreviated title :
Stroke
Volume number :
48
Pages :
2084-+
Publication date :
2017-08-01
ISSN :
0039-2499
English keyword(s) :
cerebral hemorrhage
stroke
prevalence
magnetic resonance imaging
cerebral small vessel disease
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
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 ...
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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<0.001) but not symptomatic ICH. Both cerebral amyloid angiopathy and noncerebral amyloid angiopathy patterns of CMBs were associated with PH and PHr. Increasing CMB burden category was associated with the risk of symptomatic ICH ( P=0.014), PH ( P=0.013), and PHr ( P<0.00001). Five or more and >10 CMBs independently predicted poor 3- to 6-month outcome (odds ratio: 1.85; 95% confidence interval: 1.10-3.12; P=0.020; and odds ratio: 3.99; 95% confidence interval: 1.55-10.22; P=0.004, respectively). Conclusions- Increasing CMB burden is associated with increased risk of ICH (including PHr) and poor 3- to 6-month functional outcome after intravenous thrombolysis for acute ischemic stroke.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
CHU Lille
CNRS
Inserm
Université de Lille
Collections :
  • Lille Neurosciences & Cognition (LilNCog) - U 1172
Research team(s) :
Troubles cognitifs dégénératifs et vasculaires
Submission date :
2019-11-27T14:32:31Z
Université de Lille

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