White matter lesions and intra-arterial thrombolysis

Jung, Simon; Mono, Marie Luise; Findling, Oliver; Fischer, Urs; Galimanis, Aekaterini; Weck, Anja; De Marchis, Gian Marco; Ballinari, Pietro; Gralla, Jan; Brekenfeld, Caspar; Schroth, Gerhard; Arnold, Marcel; Mattle, Heinrich P; El-Koussy, Marwan (2012). White matter lesions and intra-arterial thrombolysis. Journal of neurology, 259(7), pp. 1331-1336. Heidelberg: Springer-Verlag 10.1007/s00415-011-6352-y

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The aim of the study was to assess the influence of white matter lesions in patients with acute ischemic stroke treated with intra-arterial thrombolysis (IAT). From September 2003 to January 2010, we treated 400 patients with IAT at our institution. Of these patients, 292 were evaluated with MRI scans and included in this observational study. Clinical data were collected prospectively. Outcome after 3 months was measured with the modified Rankin Scale (mRS); mRS 0-1 was considered as favorable outcome. White matter lesions were scored visually by two observers using the semiquantitative Scheltens and Fazekas scores. Logistic regression analysis was used to identify the association of white matter lesions and clinical outcome, recanalization, and cerebral hemorrhage. The severity of white matter lesions was inversely correlated with favorable outcome, survival and successful recanalization. White matter lesions were an independent predictor of outcome (OR 0.569, p = 0.007) and survival (OR 0.550, p = 0.018) and a weak but independent predictor for recanalization (OR 0.949, p = 0.038). Asymptomatic intracerebral bleeding after IAT was associated with white matter lesions in the basal ganglia in the univariate analysis (p = 0.036), but not after multivariable analysis. The severity of white matter lesions independently predicts clinical outcome and survival in patients treated with IAT. White matter lesions are also a weak but independent predictor for recanalization. Symptomatic intracranial bleeding after IAT are not associated with white matter lesions. Therefore, white matter lesions should not be considered as a contraindication against IAT.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
07 Faculty of Human Sciences > Institute of Psychology > Cognitive Psychology, Perception and Methodology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Jung, Simon; Mono, Marie-Luise; Findling, Oliver; Fischer, Urs; Galimanis, Aekaterini; Weck, Anja; De Marchis, Gian Marco; Ballinari, Pietro; Gralla, Jan; Schroth, Gerhard; Arnold, Marcel; Mattle, Heinrich and El-Koussy, Marwan

Subjects:

600 Technology > 610 Medicine & health
100 Philosophy > 150 Psychology

ISSN:

0340-5354

Publisher:

Springer-Verlag

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 14:17

Last Modified:

26 Jun 2018 13:07

Publisher DOI:

10.1007/s00415-011-6352-y

PubMed ID:

22249288

Web of Science ID:

000306125700011

BORIS DOI:

10.7892/boris.4906

URI:

https://boris.unibe.ch/id/eprint/4906 (FactScience: 209557)

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