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Does microbleed predict haemorrhagic transformation after acute atherothrombotic or cardioembolic stroke?

Cited 29 time in Web of Science Cited 35 time in Scopus
Authors
Lee, S-H; Kang, B-S; Kim, N; Roh, J-K
Issue Date
2008-01-12
Publisher
BMJ Publishing Group
Citation
J Neurol Neurosurg Psychiatry 2008;79:913-916
Keywords
Anticoagulants/adverse effects/therapeutic useAtherosclerosis/*complications/drug therapyCerebral Hemorrhage/chemically induced/*diagnosisCerebral Infarction/*diagnosis/drug therapyEmbolism/*complications/drug therapyHeart Diseases/*complications/drug therapyIntracranial Embolism/*diagnosis/drug therapyIschemic Attack, Transient/complications/drug therapyMagnetic Resonance ImagingPlatelet Aggregation Inhibitors/adverse effects/therapeutic useRisk FactorsThrombolytic Therapy
Abstract
OBJECTIVES: Cerebral microbleeds (MBs) are known to be indicative of bleeding-prone microangiopathy and may predict incident intracerebral haemorrhage. However, there is controversy concerning the causal relationship between the presence of MBs and haemorrhagic transformation (HTf) after ischaemic stroke. METHODS: Of the 1034 patients with acute ischaemic stroke who were consecutively admitted to our hospital, 377 patients with stroke due to large-artery atherothrombosis or cardioembolism were selected for participation in this study. We examined the MBs using T2*-weighted gradient-echo MRI performed within 24 hours after admission, and the incidence of HTf was assessed using follow-up brain MRI during the hospitalisation period. RESULTS: Of the 377 patients with stroke, 234 were male (62.1%) and the mean age was 66.2 +/-11.7 years. MBs were initially found in 109 patients (28.9%), and newly incident HTf was noted during the hospitalisation period in 74 patients (19.6%). The presence of MBs was not increased in the patients with HTf (24.3% vs. 30.0% in the patients without HTf; p = 0.331). In addition, the number of MBs was not higher in the patients with HTf (0.7+/-1.5 vs. 1.8+/-8.1; p = 0.234). This lack of significance between MBs and HTf persisted after stratification by stroke mechanism. CONCLUSIONS: This study suggests that underlying MBs do not predict incident HTf after acute ischaemic stroke. The clinical significance of MBs should be differentially evaluated according to the type of disease (intracerebral haemorrhage vs. HTf).
ISSN
1468-330X (Electronic)
Language
English
URI
http://hdl.handle.net/10371/62021
DOI
https://doi.org/10.1136/jnnp.2007.133876
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Neurology (신경과학교실)Journal Papers (저널논문_신경과학교실)
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