Relationship between white matter lesion and symptomatic intracranial hemorrhage after intravenous thrombolysis in patients with acute ischemic stroke
Wang Xiaohan
Pan Yan
Zhang Xiaolin
Zhang Xiangdong
Abstract：Objective To analyze the relationship between white matter lesions and symptomatic intracranial hemorrhage(sICH)after intravenous thrombolysis in patients with acute ischemic stroke.Methods The clinical data of 400 patients with acute ischemic stroke eligible for thrombolysis were analyzed retrospectively.Based on magnetic resonance imaging,the cerebral white matter lesions were quantitatively scored with the modified LA grading scale(age-related white matter changes,ARWMC).The patients were re-examined with head CT within 24 hours after intravenous application of recombinant tissue plasminogen activator(rt-PA)and were divided into sICH group(n=29)and non-sICH group(n=371)based on whether sICH occurred.The ARWMC scores and lesion volumes of white matter were compared between the two groups,and logistic regression was used to analyze the factors influencing sICH after thrombolysis.The receiver operating characteristic(ROC)curves were drawn to analyze the predictive efficacy of ARWMC scores and lesion volumes of white matter for the occurrence of sICH after thrombolysis.Results The incidence of sICH after intravenous thrombolysis was 7.25%(29/400)in the 400 patients.The proportion of diabetes history,NIHSS scores,the proportion of large artery atherosclerosis,fibrinogen levels,ARWMC scores,and cerebral white matter lesion volume were all higher in the sICH group compared to the non-sICH group(P<0.05).The ROC curve showed that the area under the curve(AUC)for predicting sICH in patients using ARWMC scores,white matter lesion volumes,and the combination of the two were 0.825,0.861,and 0.938 respectively.Conclusions The cerebral white matter lesion scores and volumes of white matter lesions are related to sICH after intravenous thrombolysis in patients with acute ischemic stroke and can be used as predictors.
Keywords：ischemic strokeacutewhite matter lesionintravenous thrombolysissymptomatic intracranial hemorrhage
Publication Date：2024-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 209-214 )