Leukoaraiosis is a risk factor for symptomatic intracerebral hemorrhage after thrombolysis for acute stroke.
OBJECTIVE
The aim of the study was to evaluate whether leukoaraiosis (LA) is a risk factor for symptomatic intracerebral hemorrhage (sICH) in patients treated with thrombolysis for acute stroke.


METHODS
In this retrospective, multicenter analysis, we evaluated data from acute anterior circulation stroke patients (n=449; <6 hours after symptom onset) treated with thrombolysis. All patients had received standard magnetic resonance imaging evaluation before thrombolysis, including a high-quality T2-weighted sequence. For the analysis, LA in the deep white matter was dichotomized into absent or mild versus moderate or severe (corresponding to Fazekas scores of 0 to 1 versus 2 to 3).


RESULTS
The rate of sICH was significantly more frequent in patients with moderate to severe LA of the deep white matter (n=12 of 114; 10.5%) than in patients without relevant LA (n=13 of 335; 3.8%), corresponding to an odds ratio of 2.9 (95% CI, 1.29 to 6.59; P=0.015). In a logistic-regression analysis (including age, National Institutes of Health Stroke Scale score at presentation, and type of thrombolytic treatment), LA remained a significant independent risk factor (odds ratio, 2.9; P=0.03).


CONCLUSIONS
LA of the deep white matter is an independent risk factor for sICH after thrombolytic treatment for acute stroke.
Neumann-Haefelin
Tobias
T
Klinik für Neurologie, ZNN, Klinikum der Goethe-Universität, Schleusenweg 2-16, 60528 Frankfurt, Germany. tnh@rz.uni-frankfurt.de
Hoelig
Silke
S
Berkefeld
Joachim
J
Fiehler
Jens
J
Gass
Achim
A
Humpich
Marek
M
Kastrup
Andreas
A
Kucinski
Thomas
T
Lecei
Olivera
O
Liebeskind
David S
DS
Rother
Joachim
J
Rosso
Charlotte
C
Samson
Yves
Y
Saver
Jeffrey L
JL
Yan
Bernhard
B
D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000139:chemically induced / Q000453:epidemiology*; D004198:Disease Susceptibility; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D049292:Leukoaraiosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016037:Single-Blind Method; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects*
D005343:Fibrinolytic Agents