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Open Access 01-01-2019 | Short Report

Previous chronic symptomatic and asymptomatic cerebral hemorrhage in patients with acute ischemic stroke

Authors: Ge-Fei Li, Yi-Lan Wu, Shuo Wang, Yan-Hui Shi, Rong Zhao, Feng-Di Liu, Yi-Sheng Liu, Mei-Ting Zhuang, Ying Zhao, Qi Sun, Guo-Hong Cui, Jian-Ren Liu

Published in: Neuroradiology | Issue 1/2019

Abstract

Purpose

Identifying previous chronic cerebral hemorrhage (PCH), especially asymptomatic cases in patients with ischemic stroke, is essential for proper antithrombotic management. The study aimed to further clarify the prevalence of PCH and the associated factors in patients with acute ischemic stroke using multi-modal neuroimaging including susceptibility-weighted MR imaging (SWI).

Methods

This was a retrospective cross-sectional study of 382 patients with acute ischemic stroke. All patients underwent 3.0-T MRI for cranial SWI, 1.5-T or 3.0-T conventional cranial MRI, and cranial CT. Patients found with PCH were matched 1:4 with patients without PCH. Clinical manifestation, computed tomography, conventional cranial MRI, and cranial SWI were used to determine PCH. Clinical and neuroimaging findings between the patients with symptomatic vs. asymptomatic PCH were compared.

Results

Thirty-six patients (36/382, 9.4%) were determined to have had a PCH. Of these 36 patients, 17 (17/36, 47.2%, or 17/382, 4.5%) had asymptomatic PCH. Multivariable analysis showed that serum total cholesterol (OR = 0.510, 95%CI 0.312–0.832, P = 0.007), cerebral microbleeds (OR = 6.251, 95%CI 2.220–17.601, P = 0.001), and antithrombotic drugs history (OR = 3.213, 95%CI 1.018–10.145, P = 0.047) were independently associated with PCH. Asymptomatic PCH had similar clinical and neuroimaging characteristics with symptomatic PCH.

Conclusion

PCH is not uncommon in acute ischemic stroke patients. Total serum cholesterol, cerebral microbleeds on SWI, and history of antithrombotic drugs were independently associated with PCH in patients with acute ischemic stroke. Asymptomatic PCH, which is easier to be missed and has similar characteristics with symptomatic PCH, should draw much attention.

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Title: Previous chronic symptomatic and asymptomatic cerebral hemorrhage in patients with acute ischemic stroke
Authors: Ge-Fei Li
Yi-Lan Wu
Shuo Wang
Yan-Hui Shi
Rong Zhao
Feng-Di Liu
Yi-Sheng Liu
Mei-Ting Zhuang
Ying Zhao
Qi Sun
Guo-Hong Cui
Jian-Ren Liu
Publication date: 01-01-2019
Publisher: Springer Berlin Heidelberg
Published in: Neuroradiology / Issue 1/2019
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-018-2141-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Previous chronic symptomatic and asymptomatic cerebral hemorrhage in patients with acute ischemic stroke

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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