title: Detection and significance of incidental unruptured cerebral aneurysms in patients undergoing intravenous thrombolysis for acute ischemic stroke.
abstract: BACKGROUND
  It is still controversial whether intravenous (IV) thrombolysis for acute ischemic stroke increases the risk of aneurysmal bleeding. We sought to find the risk for aneurysmal bleeding after IV thrombolysis in ischemic stroke patients with unruptured cerebral aneurysms.
  
  
  METHODS
  We retrospectively analyzed consecutive patients with acute ischemic stroke who had received IVT between August 2006 and November 2009. Immediately after IV-tissue plasminogen activator (tPA) therapy (.9 mg/kg), patients underwent CT angiography, MR angiography. After that, all patients underwent follow-up angiography within 36 hours of the initiation of IV thrombolysis. Aneurysm-related hemorrhage was defined as a hemorrhage that was related to the aneurysm site.
  
  
  RESULTS
  A total of 201 patients were analyzed, and 8 (4.1%) had unruptured cerebral aneurysms. Of the 8 patients, 4 had aneurysms over 5 mm of the longest diameter. Three patients had intracerebral hemorrhage that developed at the site of infarction, which was unrelated to the aneurysms.
  
  
  CONCLUSIONS
  The results of this study suggest that IV thrombolysis might not increase the risk of aneurysmal bleeding in acute stroke patients with unruptured aneurysm < 10 mm in diameter. Further studies with a larger sample size are needed to confirm our result.
authors.affiliation: Department of Neurology, Cerebrovascular Center, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Joon-Tae
authors.initials: JT
authors.lastname: Kim
authors.forename: Man-Seok
authors.initials: MS
authors.lastname: Park
authors.forename: Woong
authors.initials: W
authors.lastname: Yoon
authors.forename: Ki-Hyun
authors.initials: KH
authors.lastname: Cho
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002533:Cerebral Angiography; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator