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Updated: Jun 26, 2026

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

[Stroke MRI for risk assessment of intracerebral hemorrhage associated with thrombolytic therapy]

O C Singer1, J Fiehler, J Berkefeld

  • 1Klinik für Neurologie, Goethe-Universität Frankfurt, Schleusenweg 2-16, 60528, Frankfurt/Main, Deutschland. o.singer@em.uni-frankfurt.de

Der Nervenarzt
|January 23, 2009
PubMed

Insights

Severe cerebral microangiopathy and large diffusion-weighted imaging (DWI) lesions increase the risk of symptomatic intracerebral hemorrhage (sICH) after thrombolytic therapy for acute stroke. A few cerebral microbleeds do not significantly elevate this risk.

Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Context:

  • Thrombolytic therapy is crucial for acute stroke treatment.
  • Symptomatic intracerebral hemorrhage (sICH) is a serious complication of thrombolysis.
  • Accurate risk assessment is needed to optimize patient selection for thrombolysis.

Purpose:

  • To summarize recent advancements in MRI-based risk assessment for sICH.
  • To evaluate the predictive value of specific imaging parameters for sICH risk.

Summary:

  • Severe cerebral microangiopathy and larger lesion volumes on diffusion-weighted imaging (DWI) are established risk factors for sICH post-thrombolysis.
  • The presence of a few cerebral microbleeds is not significantly associated with an increased risk of sICH.
  • MRI parameters like cerebral microangiopathy and DWI lesion size are key for assessing sICH risk.

Impact:

  • Improved patient stratification for thrombolytic therapy in acute stroke.
  • Enhanced understanding of MRI's role in predicting treatment complications.
  • Potential reduction in adverse events associated with stroke thrombolysis.

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