title: Leukoaraiosis and early neurological recovery after intravenous thrombolysis.
abstract: BACKGROUND
  Early neurological recovery after intravenous thrombolysis (IVT) is associated with favorable outcome after acute ischemic stroke. Leukoaraiosis, a marker of chronic ischemia, is a possible negative predictive factor of early recovery. However, its negative attenuating effects remain inadequately studied, leading to uncertainty in the prediction of outcomes after IVT. We aim to determine the influence of leukoaraiosis on early neurologic recovery.
  
  
  METHODS
  We included consecutive acute ischemic stroke patients who received IVT between 2007 and 2011. The following data were included: demographics, vascular risk factors, stroke type, National Institutes of Health Stroke Scale (NIHSS) at onset, and at 24 hours after IVT. Baseline computed tomography (CT) brain scans were analyzed. Two blinded assessors rated the CT scans using the van Swieten scale for leukoaraiosis. Median regression was used to assess the relationship between leukoaraiosis and neurologic recovery.
  
  
  RESULTS
  We included 158 patients. The median (interquartile range [IQR]) age was 77 (68-84) and 71 (45%) were female. The median (IQR) NIHSS was 13 (7-18.75) at baseline and 7.5 (2-16) at 24 hours. After taking into account variables independently associated with leukoaraiosis, median regression analysis failed to demonstrate the association between the presence of leukoaraiosis and early neurologic recovery (NIHSS relative one) after IVT, for either of the 3 prespecified dichotomization-based definitions of leukoaraiosis.
  
  
  CONCLUSIONS
  In our sample, there was no evidence of the association between the degree of leukoaraiosis and early neurological recovery after IVT.
authors.affiliation: Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: Heidi
authors.initials: H
authors.lastname: McAlpine
authors.affiliation: Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; Department of Mathematics and Statistics, The University of Melbourne, Australia.
authors.forename: Leonid
authors.initials: L
authors.lastname: Churilov
authors.affiliation: Neurointervention Service, Department of Radiology, Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: Mitchell
authors.affiliation: Neurointervention Service, Department of Radiology, Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Dowling
authors.affiliation: Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Teo
authors.affiliation: Melbourne Brain Centre, Royal Melbourne Hospital, Melbourne, Australia; Neurointervention Service, Department of Radiology, Royal Melbourne Hospital, Melbourne, Australia. Electronic address: Bernard.yan@mh.org.au.
authors.forename: Bernard
authors.initials: B
authors.lastname: Yan
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000473:pathology / Q000628:therapy; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D006801:Humans; D007275:Injections, Intravenous; D049292:Leukoaraiosis / Q000473:pathology*; D008297:Male; D020127:Recovery of Function; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000473:pathology* / Q000628:therapy*; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents
keywords: Leukoaraiosis; recovery; stroke; thrombolysis; white matter hyperintensity of presumed vascular origin