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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Previous chronic symptomatic and asymptomatic cerebral hemorrhage in patients with acute ischemic stroke

Ge-Fei Li1,2, Yi-Lan Wu1,2, Shuo Wang1

  • 1Department of Neurology, Comprehensive Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China.

Neuroradiology
|November 30, 2018
PubMed

Insights

Previous chronic cerebral hemorrhage (PCH) affects nearly 10% of ischemic stroke patients. Identifying PCH, including asymptomatic cases, is crucial for effective antithrombotic management and stroke care.

Area of Science:

  • Neurology
  • Radiology
  • Cardiovascular Medicine

Background:

  • Identifying previous chronic cerebral hemorrhage (PCH) in ischemic stroke patients is vital for appropriate antithrombotic therapy.
  • Asymptomatic PCH cases are often overlooked but clinically significant.

Purpose of the Study:

  • To determine the prevalence of PCH in acute ischemic stroke patients.
  • To identify factors associated with PCH using multi-modal neuroimaging, including susceptibility-weighted MR imaging (SWI).

Main Methods:

  • Retrospective cross-sectional study of 382 acute ischemic stroke patients.
  • Utilized 3.0-T cranial SWI, conventional MRI, and CT for PCH detection.
  • Matched PCH patients (n=36) 1:4 with non-PCH patients for analysis.

Main Results:

  • PCH was present in 9.4% of patients (36/382), with 4.5% (17/382) being asymptomatic.
  • Independent predictors of PCH included lower serum total cholesterol, presence of cerebral microbleeds on SWI, and a history of antithrombotic drug use.
  • Asymptomatic PCH shared similar clinical and neuroimaging features with symptomatic PCH.

Conclusions:

  • PCH is a common finding in patients with acute ischemic stroke.
  • Serum total cholesterol, cerebral microbleeds, and antithrombotic drug history are independently associated with PCH.
  • Asymptomatic PCH warrants attention due to its prevalence and similar characteristics to symptomatic PCH.
Abstract

Keywords:
Ischemic strokePrevious chronic cerebral hemorrhageSusceptibility-weighted MR imaging

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