Leukoaraiosis and risk of intracranial hemorrhage and outcome after stroke thrombolysis

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background The impact of leukoaraiosis on the risk of symptomatic intracerebral hemorrhage (SICH) after stroke thrombolysis is conflicting, and the data on Asian populations are lacking. Therefore, in this study, we assessed the association between leukoaraiosis and SICH, and the association between leukoaraiosis and the 90-day functional outcome in the Asian population. Methods Data were collected from a two-center prospective registry of acute ischemic stroke patients given intravenous tissue plasminogen activator between 2006 and 2014. A total of 614 pretreatment brain CT and 455 posttreatment MRI were retrospectively assessed using two different rating scales for the presence of leukoaraiosis. Outcome measures were the occurrence of SICH with three definitions and any hemorrhage after thrombolysis and functional outcome at 3 months. Results Of the 614 patients assessed, 30.3% showed severe leukoaraiosis on the baseline brain CT. The SICH rate was 4.6% - 7.2% based on different definitions, and overall, 24.9% of patients showed any post-tPA hemorrhage. No association was observed between the severity of leukoaraiosis and SICH, regardless of having used different leukoaraiosis rating scales or as assessment using different imaging modalities. However, severe leukoaraiosis was independently associated with poor functional outcome at 3 months (OR 1.96, 95% C1 1.24–3.11, P = 0.004) after adjustment for confounders. Conclusions Our results showed no association between leukoaraiosis and the risk of SICH. Although the presence of severe leukoaraiosis predicted a poor functional outcome after stroke, IV thrombolysis might not be withheld in acute ischemic stroke patients solely based on the presence of severe leukoaraiosis on pre-thrombolytic CT scans.

Original languageEnglish
Article numbere0196505
JournalPloS one
Volume13
Issue number5
DOIs
Publication statusPublished - 2018 May

Fingerprint

Leukoaraiosis
Intracranial Hemorrhages
stroke
hemorrhage
Brain
Stroke
Cerebral Hemorrhage
Computerized tomography
Tissue Plasminogen Activator
Magnetic resonance imaging
Imaging techniques
rating scales
t-plasminogen activator
brain
Hemorrhage
computed tomography
pretreatment
image analysis
Population
Registries

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

@article{9583baca0c40443888bc4fbdcf66ca9b,
title = "Leukoaraiosis and risk of intracranial hemorrhage and outcome after stroke thrombolysis",
abstract = "Background The impact of leukoaraiosis on the risk of symptomatic intracerebral hemorrhage (SICH) after stroke thrombolysis is conflicting, and the data on Asian populations are lacking. Therefore, in this study, we assessed the association between leukoaraiosis and SICH, and the association between leukoaraiosis and the 90-day functional outcome in the Asian population. Methods Data were collected from a two-center prospective registry of acute ischemic stroke patients given intravenous tissue plasminogen activator between 2006 and 2014. A total of 614 pretreatment brain CT and 455 posttreatment MRI were retrospectively assessed using two different rating scales for the presence of leukoaraiosis. Outcome measures were the occurrence of SICH with three definitions and any hemorrhage after thrombolysis and functional outcome at 3 months. Results Of the 614 patients assessed, 30.3{\%} showed severe leukoaraiosis on the baseline brain CT. The SICH rate was 4.6{\%} - 7.2{\%} based on different definitions, and overall, 24.9{\%} of patients showed any post-tPA hemorrhage. No association was observed between the severity of leukoaraiosis and SICH, regardless of having used different leukoaraiosis rating scales or as assessment using different imaging modalities. However, severe leukoaraiosis was independently associated with poor functional outcome at 3 months (OR 1.96, 95{\%} C1 1.24–3.11, P = 0.004) after adjustment for confounders. Conclusions Our results showed no association between leukoaraiosis and the risk of SICH. Although the presence of severe leukoaraiosis predicted a poor functional outcome after stroke, IV thrombolysis might not be withheld in acute ischemic stroke patients solely based on the presence of severe leukoaraiosis on pre-thrombolytic CT scans.",
author = "Yang, {Chun Ming} and Hung, {Chien Ling} and Su, {Hui Chen} and Lin, {Huey Juan} and Chen, {Chih Hung} and Lin, {Chou Ching} and Hu, {Han Hwa} and Lin, {Sheng Hsiang} and Sung, {Pi Shan}",
year = "2018",
month = "5",
doi = "10.1371/journal.pone.0196505",
language = "English",
volume = "13",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "5",

}

Leukoaraiosis and risk of intracranial hemorrhage and outcome after stroke thrombolysis. / Yang, Chun Ming; Hung, Chien Ling; Su, Hui Chen; Lin, Huey Juan; Chen, Chih Hung; Lin, Chou Ching; Hu, Han Hwa; Lin, Sheng Hsiang; Sung, Pi Shan.

In: PloS one, Vol. 13, No. 5, e0196505, 05.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Leukoaraiosis and risk of intracranial hemorrhage and outcome after stroke thrombolysis

AU - Yang, Chun Ming

AU - Hung, Chien Ling

AU - Su, Hui Chen

AU - Lin, Huey Juan

AU - Chen, Chih Hung

AU - Lin, Chou Ching

AU - Hu, Han Hwa

AU - Lin, Sheng Hsiang

AU - Sung, Pi Shan

PY - 2018/5

Y1 - 2018/5

N2 - Background The impact of leukoaraiosis on the risk of symptomatic intracerebral hemorrhage (SICH) after stroke thrombolysis is conflicting, and the data on Asian populations are lacking. Therefore, in this study, we assessed the association between leukoaraiosis and SICH, and the association between leukoaraiosis and the 90-day functional outcome in the Asian population. Methods Data were collected from a two-center prospective registry of acute ischemic stroke patients given intravenous tissue plasminogen activator between 2006 and 2014. A total of 614 pretreatment brain CT and 455 posttreatment MRI were retrospectively assessed using two different rating scales for the presence of leukoaraiosis. Outcome measures were the occurrence of SICH with three definitions and any hemorrhage after thrombolysis and functional outcome at 3 months. Results Of the 614 patients assessed, 30.3% showed severe leukoaraiosis on the baseline brain CT. The SICH rate was 4.6% - 7.2% based on different definitions, and overall, 24.9% of patients showed any post-tPA hemorrhage. No association was observed between the severity of leukoaraiosis and SICH, regardless of having used different leukoaraiosis rating scales or as assessment using different imaging modalities. However, severe leukoaraiosis was independently associated with poor functional outcome at 3 months (OR 1.96, 95% C1 1.24–3.11, P = 0.004) after adjustment for confounders. Conclusions Our results showed no association between leukoaraiosis and the risk of SICH. Although the presence of severe leukoaraiosis predicted a poor functional outcome after stroke, IV thrombolysis might not be withheld in acute ischemic stroke patients solely based on the presence of severe leukoaraiosis on pre-thrombolytic CT scans.

AB - Background The impact of leukoaraiosis on the risk of symptomatic intracerebral hemorrhage (SICH) after stroke thrombolysis is conflicting, and the data on Asian populations are lacking. Therefore, in this study, we assessed the association between leukoaraiosis and SICH, and the association between leukoaraiosis and the 90-day functional outcome in the Asian population. Methods Data were collected from a two-center prospective registry of acute ischemic stroke patients given intravenous tissue plasminogen activator between 2006 and 2014. A total of 614 pretreatment brain CT and 455 posttreatment MRI were retrospectively assessed using two different rating scales for the presence of leukoaraiosis. Outcome measures were the occurrence of SICH with three definitions and any hemorrhage after thrombolysis and functional outcome at 3 months. Results Of the 614 patients assessed, 30.3% showed severe leukoaraiosis on the baseline brain CT. The SICH rate was 4.6% - 7.2% based on different definitions, and overall, 24.9% of patients showed any post-tPA hemorrhage. No association was observed between the severity of leukoaraiosis and SICH, regardless of having used different leukoaraiosis rating scales or as assessment using different imaging modalities. However, severe leukoaraiosis was independently associated with poor functional outcome at 3 months (OR 1.96, 95% C1 1.24–3.11, P = 0.004) after adjustment for confounders. Conclusions Our results showed no association between leukoaraiosis and the risk of SICH. Although the presence of severe leukoaraiosis predicted a poor functional outcome after stroke, IV thrombolysis might not be withheld in acute ischemic stroke patients solely based on the presence of severe leukoaraiosis on pre-thrombolytic CT scans.

UR - http://www.scopus.com/inward/record.url?scp=85046367352&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85046367352&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0196505

DO - 10.1371/journal.pone.0196505

M3 - Article

C2 - 29715283

AN - SCOPUS:85046367352

VL - 13

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 5

M1 - e0196505

ER -