This study analyzed patients with acute ischemic stroke and evaluated the risk of
developing symptomatic intracerebral hemorrhage (sICH) after the administration of
thrombolytic treatment. Patients were studied using data obtained retrospectively
from a previous multi-center prospective trial. In total, 645 patients with anterior
circulation strokes were studied. All patients received intravenous or intra-arterial
thrombolysis within 6 h of symptom onset. Patients were divided into three pre-treatment
groups based on magnetic resonance diffusion-weighted imaging (DWI) stroke lesion
size: 1) small (< 10 mL), 2) moderate (10–100 mL), and 3) large (> 100 mL). Of the
645 patients studied, 44 (6.8%) developed sICH after thrombolysis. There was a significant
difference of sICH in the three pre-treatment groups, with rates of 2.8%, 7.8%, and
16.1% in patients with small, moderate, and large DWI stroke lesions, respectively
(p < 0.05). In addition, pre-treatment DWI lesion size was an independent risk factor
for potential sICH when evaluating multiple factors with logistic regression analysis.
The authors concluded that DWI lesion size is an important risk factor for the development
of sICH after thrombolysis in acute stroke and that thrombolytics should be used judiciously
in patients with large DWI lesions.
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© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
