JOURNAL ARTICLE

Focal fluid-attenuated inversion recovery hyperintensity within acute diffusion-weighted imaging lesions is associated with symptomatic intracerebral hemorrhage after thrombolysis

A-Hyun Cho, Jong S Kim, Sang-Joon Kim, Sung-Cheol Yun, Choong-Gon Choi, Hyoung-Ryoul Kim, Sun U Kwon, Deok-Hee Lee, Eun-Kyung Kim, Dae-Chul Suh, Dong-Wha Kang
Stroke; a Journal of Cerebral Circulation 2008, 39 (12): 3424-6
18772449

BACKGROUND AND PURPOSE: We investigated whether focal hyperintensity on fluid-attenuated inversion recovery image within acute infarcts is associated with symptomatic intracerebral hemorrhage (SICH) after thrombolysis.

METHODS: Patients with acute ischemic stroke who underwent MRI screening before thrombolysis were enrolled. The presence of focal fluid-attenuated inversion recovery hyperintensity within acute infarcts did not preclude thrombolysis. SICH was defined as hemorrhagic transformation with any neurological decline (SICH-1) or with an increase in National Institutes of Health Stroke Scale of >or=4 (SICH-2) within 48 hours.

RESULTS: Among 88 included patients, focal fluid-attenuated inversion recovery hyperintensity within acute infarct lesions was observed in 27 (30.7%) patients. Multivariate analysis showed that focal fluid-attenuated inversion recovery hyperintensity was independently associated with SICH-1 (OR, 13.64; 95% CI, 1.51 to 123.28) and SICH-2 (OR, 10.44; 95% CI, 1.11 to 98.35).

CONCLUSIONS: The presence of focal fluid-attenuated inversion recovery hyperintensity within acute infarcts may increase the risk of symptomatic intracerebral hemorrhage after thrombolysis.

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