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01-10-2016 | Diagnostic Neuroradiology

Impact of leukoaraiosis on parenchymal hemorrhage in elderly patients treated with thrombolysis

Authors: Norbert Nighoghossian, Fatima Abbas, Tae-Hee Cho, Ana Filipa Geraldo, Vincent Cottaz, Elie Janecek, Laura Mechtouff, Magali Bischoff, Carlos El Khoury, Anne Marie Schott, Laurent Derex, Marc Hermier, Louis Guy Tisserand, Roxana Amelie, Leila Chamard, Yves Berthezene

Published in: Neuroradiology | Issue 10/2016

Abstract

Introduction

Severity of vascular damage of white matter may predict hemorrhagic transformation (HT). We assess the relationship between leukoaraiosis (LA) severity and the type of hemorrhagic transformation in elderly patients treated with thrombolysis.

Methods

We retrospectively analyzed the clinical data and pretreatment magnetic resonance imaging (MRI) of 180 consecutive ischemic stroke patients aged over 75 years. LA severity was graded according to the Fazekas scale, and acute diffusion-weighted-imaging (DWI) lesion volumes were semi-automatically outlined. Predictors of hemorrhagic infarction (HI) and parenchymal hemorrhage (PH) were identified using logistic regression analysis and exact multinomial logistic analysis.

Results

HT occurred in 31 patients (17 %). Baseline National Institute of Health Stroke Score (NIHSS; p = 0.008), severe LA (p = 0.02), and diffusion lesion volume (p = 0.02) were predictors of HT in univariable logistic regression. Adjusted to lesion volume and baseline NIHSS score, exact multinomial logistic analysis showed that severe LA was the only independent predictor of parenchymal hemorrhage (p = 0.03).

Conclusion

In elderly patients, LA severity better predicts parenchymal hemorrhage than infarct size.

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Title: Impact of leukoaraiosis on parenchymal hemorrhage in elderly patients treated with thrombolysis
Authors: Norbert Nighoghossian
Fatima Abbas
Tae-Hee Cho
Ana Filipa Geraldo
Vincent Cottaz
Elie Janecek
Laura Mechtouff
Magali Bischoff
Carlos El Khoury
Anne Marie Schott
Laurent Derex
Marc Hermier
Louis Guy Tisserand
Roxana Amelie
Leila Chamard
Yves Berthezene
Publication date: 01-10-2016
Publisher: Springer Berlin Heidelberg
Published in: Neuroradiology / Issue 10/2016
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-016-1725-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Impact of leukoaraiosis on parenchymal hemorrhage in elderly patients treated with thrombolysis

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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