Background and Purpose-The aim of the study was to evaluate whether leukoaraiosis (LA) is a risk factor for symptomatic intracerebral hemorrhage (sICH) in patients treated with thrombolysis for acute stroke. Methods-In this retrospective, multicenter analysis, we evaluated data from acute anterior circulation stroke patients (nϭ449; Ͻ6 hours after symptom onset) treated with thrombolysis. All patients had received standard magnetic resonance imaging evaluation before thrombolysis, including a high-quality T2-weighted sequence. For the analysis, LA in the deep white matter was dichotomized into absent or mild versus moderate or severe (corresponding to Fazekas scores of 0 to 1 versus 2 to 3). Results-The rate of sICH was significantly more frequent in patients with moderate to severe LA of the deep white matter (nϭ12 of 114; 10.5%) than in patients without relevant LA (nϭ13 of 335; 3.8%), corresponding to an odds ratio of 2.9 (95% CI, 1.29 to 6.59; Pϭ0.015). In a logistic-regression analysis (including age, National Institutes of Health Stroke Scale score at presentation, and type of thrombolytic treatment), LA remained a significant independent risk factor (odds ratio, 2.9; Pϭ0.03). Conclusions-LA of the deep white matter is an independent risk factor for sICH after thrombolytic treatment for acute stroke.

Heart rate variability (HRV) reflects the cardiac autonomic regulation, and reduced HRV is considered a pathophysiological link between depression and cardiovascular mortality. So far, there is only limited information on the effects of venlafaxine and mirtazapine on HRV.We studied 28 nondepressed controls and 41 moderately depressed patients being treated with venlafaxine (n = 20) and mirtazapine (n = 21). Heart rate, blood pressure, and HRV were measured after a 6-day washout as well as after 14 and 28 days of treatment in supine and upright position.We found increased heart rate and reduced HRV in the depressed patients compared with the nondepressed controls. Moreover, HRV total power declined during the treatment period. Medication and remission status after 4 weeks were not related to the change in HRV.We conclude that depression is related to reduced HRV, which might reflect sympathovagal dysbalance. The widely used antidepressants venlafaxine and mirtazapine led to further decline in HRV. Clinicians should consider HRV effects in the selection of antidepressants.