title: Extensive cerebral microbleeds predict parenchymal haemorrhage and poor outcome after intravenous thrombolysis.
abstract: OBJECTIVE
  Thrombolysis-related haemorrhagic transformation (HT) subtypes may have different prognostic implications. We aimed to analyse the impact of cerebral microbleeds (CMBs) burden on HT subtypes and outcome after intravenous thrombolysis.
  
  
  METHODS
  We retrospectively examined clinical and radiological data from 333 consecutive patients with acute ischaemic stroke who underwent susceptibility-weighted imaging before intravenous thrombolysis. Logistic regression analysis was used to determine the impact of CMBs on HT subtypes and neurological outcome.
  
  
  RESULTS
  We observed 596 CMBs in 119 (39.7%) patients on initial gradient-recalled echo scans. HT occurred in 88 (29.3%) patients, among which 62 were haemorrhagic infarction and 26 were parenchymal haemorrhage (PH). Logistic regression analysis indicated that the presence of extensive (≥ 3) CMBs was independently associated with PH (OR 6.704; 95% CI 2.054 to 21.883; p = 0.002) and poor clinical outcome (OR 2.281; 95% CI 1.022 to 5.093; p = 0.044).
  
  
  CONCLUSIONS
  The presence of extensive (≥ 3) CMBs increased the risk of PH 24 h after intravenous thrombolysis, and predicted poor clinical outcome independently.
authors: Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
authors: Shenqiang
authors: S
authors: Yan
authors: Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
authors: Xinchun
authors: X
authors: Jin
authors: Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
authors: Xuting
authors: X
authors: Zhang
authors: Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
authors: Sheng
authors: S
authors: Zhang
authors: University of California-Los Angeles Stroke Center, Los Angeles, California, USA.
authors: David S
authors: DS
authors: Liebeskind
authors: Department of Neurology, The 2nd Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
authors: Min
authors: M
authors: Lou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy*; D002544:Cerebral Infarction / Q000453:epidemiology / Q000209:etiology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D020521:Stroke / Q000628:therapy; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: MRI; NEURORADIOLOGY; STROKE