Early infarct FLAIR hyperintensity is associated with increased hemorrhagic transformation after thrombolysis.
Summary of "Early infarct FLAIR hyperintensity is associated with increased hemorrhagic transformation after thrombolysis."
Absence of FLAIR hyperintensity within an acute infarct is associated with stroke onset <4.5 h. However, some patients rapidly develop FLAIR hyperintensity within this timeframe. We hypothesized that development of early infarct FLAIR hyperintensity would predict hemorrhagic transformation (HT) in sub-4.5 h tPA patients.
Consecutive acute stroke patients treated with IV tPA <4.5 h after onset who had MRI before and one day after thrombolysis were included. Two raters (blind to HT) independently identified FLAIR hyperintensity with reference to the DWI lesion. HT was assessed using T2* MRI at 24 h. Hemorrhagic infarction (HI) was defined as petechial HT without mass effect, and parenchymal hematoma (PH) as HT with mass effect. Multivariable logistic regression analysis for HT included FLAIR status, baseline NIHSS and DWI lesion volume, leukoaraiosis (Wahlund score), serum glucose and reperfusion.
Of 109 patients, 33 (30%) had acute FLAIR hyperintensity. HT occurred in 17 patients (15.6%; 15 HI, 2 PH). HT was more common in FLAIR-positive patients than FLAIR-negative patients (33.3% vs. 9.2%, P = 0.009). Median time-to-scan and median time-to-thrombolysis did not differ significantly between patients with HT and without (97 IQR[68, 155] vs. 90 IQR[73, 119], P = 0.5; 120 IQR[99, 185] vs. 125 IQR[95, 150], P = 0.6, respectively). In multivariable analysis, only FLAIR hyperintensity was independently associated with HT after thrombolysis (
18; 95% CI 2 to 175, P = 0.013).
Early development of FLAIR hyperintensity within the area of diffusion-restriction is associated with increased risk of HT after thrombolysis in acute stroke patients.
International Graduate Program Medical Neurosciences, Charité - Universitätsmedizin Berlin, Berlin, Germany.
This article was published in the following journal.
Name: European journal of neurology : the official journal of the European Federation of Neurological Societies
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22900825
- DOI: http://dx.doi.org/10.1111/j.1468-1331.2012.03841.x
Medical and Biotech [MESH] Definitions
Hemorrhagic Fevers, Viral
A group of viral diseases of diverse etiology but having many similar clinical characteristics; increased capillary permeability, leukopenia, and thrombocytopenia are common to all. Hemorrhagic fevers are characterized by sudden onset, fever, headache, generalized myalgia, backache, conjunctivitis, and severe prostration, followed by various hemorrhagic symptoms. Hemorrhagic fever with kidney involvement is HEMORRHAGIC FEVER WITH RENAL SYNDROME.
Hemorrhagic Disease Virus, Rabbit
A species in the genus LAGOVIRUS which causes hemorrhagic disease, including hemorrhagic septicemia, in rabbits.
Methods to determine in patients the nature of a disease or disorder at its early stage of progression. Generally, early diagnosis improves PROGNOSIS and TREATMENT OUTCOME.
Hemorrhagic Fever, Crimean
A severe, often fatal disease in humans caused by the Crimean-Congo hemorrhagic fever virus (HEMORRHAGIC FEVER VIRUS, CRIMEAN-CONGO).
Hemorrhagic Fever, Ebola
A highly fatal, acute hemorrhagic fever, clinically very similar to MARBURG VIRUS DISEASE, caused by EBOLAVIRUS, first occurring in the Sudan and adjacent northwestern (what was then) Zaire.
The educational objectives for this self-assessment module are for the participant to exercise, self-assess, and improve his or her understanding of the hyperintensity of the basal ganglia and cortex...
OBJECTIVE: Fluid-attenuated inversion recovery (FLAIR) vascular hyperintensities (FVH), initially described on 2D FLAIR images, are a useful imaging marker in patients with acute ischaemic stroke. We...
INTRODUCTION: Most enterovirus (EV) 71 infections manifest as mild cases of hand-foot-mouth disease (HFMD)/herpangina with seasonal variations, having peak incidence during the summer. Meanwhile, EV 7...
Bevacizumab is thought to normalize tumor vasculature and restore the blood-brain barrier, decreasing enhancement and peritumoral edema. Conventional measurements of tumor response rely upon dimension...
The purpose of this study is to confirm the long-term safety and effectiveness of the FLAIR Endovascular Stent Graft for treatment of stenoses at the venous anastomosis of ePTFE or other s...
This study compared the FLAIR™ Endovascular Stent Graft to balloon angioplasty in patients with stenoses at the venous anastomosis of a synthetic AV access graft.
The aim of the study is to evaluate the use of combined fluid attenuated inversion recovery (FLAIR) imaging and diffusion weighted imaging (DWI) as surrogate marker of lesion age within th...
Hemorrhagic Fever with Renal Syndrome (HFRS) is caused by a virus acquired by contact with chronically infected rodent hosts. HFRS is present throughout Korea. Treatment consists mainly o...
Through this study, the investigators are to prove that Cilostazol effectively prevent cardiovascular events in ischemic stroke patients with high risk of cerebral hemorrhage, along with n...