• J Stroke Cerebrovasc Dis · Sep 2016

    Observational Study

    Severe Hemorrhagic Transformation after Thrombolysis for Acute Ischemic Stroke Prevents Early Neurological Improvement.

    • Dipender Gill, Aravindhan Baheerathan, Adarsh Aravind, Roland Veltkamp, and Arindam Kar.
    • Imperial College Healthcare NHS Trust, Imperial College London, Postgraduate Centre, Hammersmith Hospital, London, United Kingdom. Electronic address: Dipender.gill@imperial.ac.uk.
    • J Stroke Cerebrovasc Dis. 2016 Sep 1; 25 (9): 2232-6.

    BackgroundIntravenous thrombolysis can improve neurological outcomes after acute ischemic stroke (AIS), but hemorrhagic transformation (HT) of the infarct remains a risk. Current definitions for symptomatic intracerebral hemorrhage (ICH) all entail that there be some degree of associated neurological deterioration. However, early deleterious effects of secondary ICH might also be manifested as reduced neurological improvement. This study aims to investigate whether there are any independent associations between different radiological subtypes of HT and the degree of neurological improvement 24 hours after thrombolysis.MethodsThis study is a retrospective analysis of a single-center database of consecutive thrombolysis cases for AIS. Multivariate regression analysis was undertaken to explore the relationship between different subtypes of HT with changes in National Institutes of Health Stroke Scale (NIHSS) score 24 hours after thrombolysis, after adjusting for potential confounders.ResultsAs compared to cases with no HT, occurrence of the parenchymal hematoma 2 (PH2) subtype of secondary ICH was independently associated with reduced improvement or worsening in the NIHSS score, with an average effect size of 7 points (95% confidence interval -10 to -4, P < .001). In the absence of PH2, thrombolysis for AIS was generally associated with an improvement in the neurological status at 24 hours.ConclusionsThe PH2 subtype of HT is associated with reduced neurological improvement or deterioration 24 hours after thrombolysis for AIS.Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…