Stroke: cerebral microbleeds predict sICH after IVT

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Takeaway

  • A high number of cerebral microbleeds (CMBs) on MRI is associated with symptomatic intracerebral hemorrhage (sICH) in patients with stroke treated with intravenous thrombolysis (IVT).

Why this matters

  • sICH is common after IVT, but hard to predict.  

Key results

  • sICH rates were similar in patients with and without CMBs (5.8% vs 3.5%; P=.27).
  • Inhospital mortality rates were similar in patients with and without CMBs (6.8% vs 5.6%; P=.65).
  • sICH rates were significantly higher in patients with >10 CMBs (30%; P<.001).
  • The presence of >10 CMBs was associated with sICH in multivariate analysis (OR, 13.4; P=.0004).

Study design

  • 672 patients with stroke treated with IVT, 103 with CMBs on MRI, were analyzed for risk for sICH.
  • Funding: None disclosed.

Limitations

  • MRI results not validated by pathology.
  • No non-IVT control group.