title: Safety of intravenous thrombolysis in acute ischemic stroke patients with saccular intracranial aneurysms.
abstract: BACKGROUND
  It is not known if the presence of unruptured intracranial aneurysms can increase the risk of hemorrhage after thrombolysis for acute ischemic stroke. The goal of our study was to evaluate the risk of hemorrhage after intravenous tissue plasminogen activator in acute stroke patients with intracranial aneurysms.
  
  
  METHODS
  This is a retrospective analysis of consecutive cases of patients with acute ischemic stroke who were treated with intravenous tissue plasminogen activator at Mayo Clinic between March 2002 and June 2011 and who were evaluated with invasive or noninvasive intracranial angiography. Univariate analyses were performed with the t, Chi-square, and Fisher exact tests where appropriate.
  
  
  RESULTS
  Intracranial angiograms were performed in 105 patients (85 magnetic resonance angiography, 19 computed tomography angiography, and 1 catheter arteriography). The mean age of the patients was 69 ± 14 years. The mean National Institutes of Health Stroke Scale score at admission was 8 ± 5. A total of 12 incidental saccular aneurysms were found in 10 (9.5%) patients, and all 10 of these patients were white. There were no subarachnoid hemorrhages during the hospital stay in any patient with or without intracranial aneurysm. The rates of symptomatic intracranial hemorrhage and 3-month clinical outcomes were similar in patients with or without intracranial aneurysms.
  
  
  CONCLUSIONS
  Intravenous thrombolysis was safe among our patients with acute ischemic stroke and incidental intracranial saccular aneurysm.
authors.affiliation: Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Manoj K
authors.initials: MK
authors.lastname: Mittal
authors.forename: Raymond C S
authors.initials: RC
authors.lastname: Seet
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.forename: Robert D
authors.initials: RD
authors.lastname: Brown
authors.forename: Alejandro A
authors.initials: AA
authors.lastname: Rabinstein
mesh_terms: D061605:Administration, Intravenous; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D002533:Cerebral Angiography / Q000379:methods; D016009:Chi-Square Distribution; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D033162:Incidental Findings; D002532:Intracranial Aneurysm / Q000150:complications* / Q000175:diagnosis; D020300:Intracranial Hemorrhages / Q000209:etiology; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D013345:Subarachnoid Hemorrhage / Q000209:etiology; D015912:Thrombolytic Therapy / Q000009:adverse effects; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator