Very Low Cerebral Blood Volume Predicts Parenchymal Hematoma in Acute Ischemic Stroke

被引:37
作者
Hermitte, Laure [1 ]
Cho, Tae-Hee [1 ]
Ozenne, Brice [2 ,3 ,4 ]
Nighoghossian, Norbert [1 ]
Mikkelsen, Irene Klaerke [5 ]
Ribe, Lars [5 ]
Baron, Jean-Claude [6 ,7 ]
Ostergaard, Leif [5 ]
Derex, Laurent [11 ]
Hjort, Niels [5 ]
Fiehler, Jens [8 ,9 ]
Pedraza, Salvador [10 ]
Hermier, Marc [1 ]
Maucort-Boulch, Delphine [2 ,3 ,4 ]
Berthezene, Yves [1 ]
机构
[1] Univ Lyon 1, CREATIS, INSA Lyon, Hosp Civils Lyon,CNRS,INSERM,UMR 5220,U1044, F-69365 Lyon, France
[2] Hosp Civils Lyon, Serv Biostat, Lyon, France
[3] Equipe Biostat Sante, CNRS, UMR 5558, Pierre Benite, France
[4] Univ Lyon 1, F-69622 Villeurbanne, France
[5] Aarhus Univ, Dept Clin Med, Ctr Functionally Integrat Neurosci, Aarhus, Denmark
[6] Univ Cambridge, Dept Clin Neurosci, Cambridge, England
[7] Univ Paris 05, INSERM, U894, Sorbonne Paris Cite, Paris, France
[8] Univ Hosp Hamburg Eppendorf, Dept Diagnost Neuroradiol, Hamburg, Germany
[9] Univ Hosp Hamburg Eppendorf, Dept Intervent Neuroradiol, Hamburg, Germany
[10] Hosp Univ Girona Dr Josep Trueta, Girona Biomed Res Inst IDIBGI, Dept Radiol IDI, Girona, Spain
[11] Hop Neurol, Lyon, France
关键词
cerebral hemodynamics; hemorrhage; ischemic stroke; perfusion imaging; thrombolysis; HEMORRHAGIC TRANSFORMATION; THROMBOLYSIS; REPERFUSION; TRIAL; ECASS; MRI;
D O I
10.1161/STROKEAHA.113.001751
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose Parenchymal hematoma (PH) may worsen the outcome of patients with stroke. The aim of our study was to confirm the relationship between the volume of very low cerebral blood volume (CBV) and PH using a European multicenter database (I-KNOW). A secondary objective was to explore the impact of early reperfusion and recanalization. Methods The volume of cerebral tissue with CBV 2.5th percentile of the normal hemisphere was calculated within the acute diffusion-weighted imaging lesion. Hemorrhagic transformation was assessed on day 2 MRI according to the European Cooperative Acute Stroke Study II criteria. Recanalization and reperfusion were assessed on 3-hour follow-up MRI. Results Of the 110 patients, hemorrhagic transformation occurred in 59 patients, including 7 PH. In univariate analysis, the acute National Institutes of Health Stroke Scale score (P=0.002), acute diffusion-weighted imaging lesion volume (P=0.02), and thrombolysis (P=0.03), but not very low CBV (P=0.52), were associated with hemorrhagic transformation. The volume of very low CBV was the only predictor of PH (P=0.007). Early reperfusion and recanalization had no influence on either hemorrhagic transformation or PH. Conclusion Very low CBV was the only independent predictor of PH in patients with acute stroke.
引用
收藏
页码:2318 / 2320
页数:3
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