on August 24, 2006
Published online before print August 24, 2006, doi: 10.1161/01.STR.0000239321.53203.ea
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Submitted on January 29, 2006
From the Klinik für Neurologie (T.N.-H., S.H., M.H.) and Institut für Neuroradiologie (J.B., B.Y.), Universitätsklinik, Goethe Universität, Frankfurt, Germany; Neuroradiologie (J.F., T.K.), Universitätsklinik Eppendorf, Hamburg, Germany; Neurologische Klinik (A.G., O.L.), Universitätsklinikum, Mannheim, Germany; Neurologische Klinik (A.K.), Universitätsklinikum, Jena, Germany; UCLA Stroke Center (D.S.L., J.L.S.), University of California, Los Angeles; Neurologische Klinik (J.R.), Klinikum Minden, Minden, Germany; and Urgences Cérébro-Vasculaires (C.R., Y.S.), Salpêtrière, AP-HP, Paris, France. * To whom correspondence should be addressed. E-mail: tnh{at}rz.uni-frankfurt.de.
Background and Purpose--The aim of the study was to evaluate whether leukoaraiosis (LA) is a risk factor for symptomatic intracerebral hemorrhage (sICH) in patients treated with thrombolysis for acute stroke. Methods--In this retrospective, multicenter analysis, we evaluated data from acute anterior circulation stroke patients (n=449; <6 hours after symptom onset) treated with thrombolysis. All patients had received standard magnetic resonance imaging evaluation before thrombolysis, including a high-quality T2-weighted sequence. For the analysis, LA in the deep white matter was dichotomized into absent or mild versus moderate or severe (corresponding to Fazekas scores of 0 to 1 versus 2 to 3). Results--The rate of sICH was significantly more frequent in patients with moderate to severe LA of the deep white matter (n=12 of 114; 10.5%) than in patients without relevant LA (n=13 of 335; 3.8%), corresponding to an odds ratio of 2.9 (95% CI, 1.29 to 6.59; P=0.015). In a logistic-regression analysis (including age, National Institutes of Health Stroke Scale score at presentation, and type of thrombolytic treatment), LA remained a significant independent risk factor (odds ratio, 2.9; P=0.03). Conclusions--LA of the deep white matter is an independent risk factor for sICH after thrombolytic treatment for acute stroke.
Revised on April 11, 2006
Accepted on May 12, 2006
Leukoaraiosis Is a Risk Factor for Symptomatic Intracerebral Hemorrhage After Thrombolysis for Acute Stroke
Tobias Neumann-Haefelin MD*;
Key words: intracerebral hemorrhage • leukoaraiosis • stroke, acute • thrombolysis
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