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Updated: Jun 28, 2026
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Published on: June 4, 2021
A risk score to predict intracranial hemorrhage after recombinant tissue plasminogen activator for acute ischemic
Brett Cucchiara1, David Tanne, Steven R Levine
1Department of Neurology, University of Pennsylvania Medical Center, Philadelphia 19104, USA. cucchiar@mail.med.upenn.edu
Background:
Ability to predict risk of postthrombolysis intracerebral hemorrhage (ICH) is currently limited.
Methods:
Using data from the Multicenter Recombinant Tissue Plasminogen Activator Stroke Survey Group, we developed a score to predict this risk. One point was assigned for the presence of each of 4 variables: age older than 60 years, baseline National Institutes of Health Stroke Scale score greater than 10, glucose greater than 8.325 mmol/L, and platelet count less than 150,000/mm(3).
Results:
Rate of any ICH increased with higher scores: 0 points, 2.6%; 1 point, 9.7%; 2 points, 15.1%; and greater than or equal to 3 points, 37.9%. The model had reasonable discriminatory capability (C-statistic 0.69). A similar pattern was seen with symptomatic and asymptomatic ICH separately, and with radiographically defined parenchymal hemorrhage.
Conclusion:
A simple risk score may be useful for predicting postthrombolysis ICH.
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