London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 649 576 Acute stroke: emergency management, stroke units and complications Predictors of Symptomatic Intracerebral Hemorrhage after Thrombolysis in Nation-wide Sample D. Vaclavik1, R. Mikulik2, P. Kadlecova3, M. Bar4 Stroke Center, Department of Neurology,Vitkovice Hospital, Ostrava, CZECH REPUBLIC1, International Clinical Research Center, Department of Neurology, St.Anne‘s University Hospital Brno, Brno, CZECH REPUBLIC2, International Clinical Research Center, Department of Neurol-ogy, St.Anne‘s University Hospital Brno, Brno, CZECH REPUBLIC3, Department of Neurology, University Hospital Ostrava, Ostrava, CZECH REPUBLIC4 Background: : Symptomatic intracerebral hemorrhage (SICH) following thrombolytic therapy for stroke is associated with a high rate of morbidity and mortality. The aim of our study was to identify predictors of SICH in patiens after systemic thrombolysis in the Czech Republic.Methods: : Data collected from the SITS registry (Safe Implementation of Treatments in Stroke) of patients from the Czech Republic treated with intravenous thrombolysis between February 2003 and February 2010 were analyzed with uni and multivariate regression analysis. The outcome variable was SICH, de-fined as deterioration in NIHSS >= 4 points and intracerbral hemorrhage type 2 in the 22-36 hours after the start of thrombolysis. Results: Overall 2821 patients were treated with intravenous throm-bolysis. SICH were observed in 60 (2,1%) patients. Multivariate regression analyses identified fol-lowing variables independetly associated with SICH: baseline NIHSS (<=12 vs >12) ( p < 0.006; OR 0.4, 95% CI 0,25-0,79 ), Glucose ( p< 0,003; OR 1.1, 95% CI 1,03-1,18), Congestive heart failure ( p<0.02; OR 2.1, 95% CI 1,1-4,01), hypertension ( p<0.043; OR 2.4, , 95% CI 1,03-5,81). Conclusions: Our data help with risk stratification afer intravenous thrombolysis: patients with more severe stroke, higher glucose level and presence of congestiva heart failure and hypertension are at higher risk of SICH. 577 Acute stroke: emergency management, stroke units and complications Perfusion-CT ASPECT score does not predict final infarct by ASPECTS after recanalization therapy for acute ischemic stroke in the anterior circulation A. Angermaier1, S. Langner2, M. Kirsch3, N. Hosten4, C. Kessler5, A.V. Khaw6 University Medicine Greifswald, Departement of Neurology, Greifswald, GERMANY1, Uni-versity Medicine Greifswald, Institute for Diagnostic Radiology and Neuroradiology, Greifswald, GERMANY2, University Medicine Greifswald, Institute for Diagnostic Radiology and Neuroradiol-ogy, Greifswald, GERMANY3, University Medicine Greifswald, Institute for Diagnostic Radiology and Neuroradiology, Greifswald, GERMANY4, University Medicine Greifswald, Departement of Neurology, Greifswald, GERMANY5, University Medicine Greifswald, Departement of Neurology, Greifswald, GERMANY6 Purpose: The ASPECTS (Alberta Stroke Program Early CT Score) has been proposed as an easy and rapid alternative to the less reliable visual estimation of tissue at risk. Our aim was to evaluate the association between admission ASPECTS for perfusion CT (PCT) parameters and final infarct ASPECTS in patients who received intraarterial thrombolysis (iaT) and to compare the results with patients treated conservatively. Methods: We enrolled 26 ischemic stroke patients (17 w, 9 m, 67.5+/-12.1y) with M1, proximal M2 or distal ICA occlusion to undergo iaT after noncontrast CT, PCT and CT angiography within 6 hours from symptom onset. The control group consisted of 20 patients matched for age and admission NIHSSS and who underwent the same imaging protocol but did not receive any reperfusion procedure. Recanalization status in the control group was assessed with TCD. Three raters, blinded for other data, scored ASPECTS values for CBF, CBV and TTP on a consensus base. These scores were compared with final infarct ASPECTS in follow-up CT (AS-PECTS- CT). Results: Recanalization occurred in 19 patients after iaT. In the control group, 6 out of 12 had spontaneous recanalization, 8 had no sufficient TCD insonation window. Mean(SD) AS-PECTS for CBF was 3.3(2.1), CBV 4.3(2.1) and TTP 1.9(1.6) in the treatment group, and 1.5(2), 2.8(2.1) and 1.5(1.7) in the control group, respectively. Mean(SD) ASPECTS-CT was 6.5(2.3) and 5.5(3.2), resp. ASPECTS for all PCT parameters were significantly lower than ASPECTS-CT in both groups. This applied to patients with successful recanalization, as compared to those without. The smallest mean difference was found between CBV and ASPECTS-CT in the non-recanalization subgroup. Discussion: The initial ASPECTS lesion was significantly larger in all PCT parameters as compared with ASPECTS-CT and was not predictive when recanalization occurred. This suggests that the initial perfusion lesion, including CBV, may be partially reversible in case of reperfusion.
Karger_ESC London_2013
To see the actual publication please follow the link above