Background and Purpose-We assessed whether the presence, number, and distribution of cerebral microbleeds (CMBs) on pre-intravenous thrombolysis MRI scans of acute ischemic stroke patients are associated with an increased risk of intracerebral hemorrhage (ICH) or poor functional outcome. Methods-We performed an individual patient data meta-analysis, including prospective and retrospective studies of acute ischemic stroke treated with intravenous tissue-type plasminogen activator. Using multilevel mixed-effects logistic regression, we investigated associations of pre-treatment CMB presence, burden (1, 2-4, ≥5, and >10), and presumed pathogenesis (cerebral amyloid angiopathy defined as strictly lobar CMBs and noncerebral amyloid angiopathy) with symptomatic ICH, parenchymal hematoma (within [parenchymal hemorrhage, PH] and remote from the ischemic area [remote parenchymal hemorrhage, PHr]), and poor 3-to 6-month functional outcome (modified Rankin score >2). We performed a large-scale pooled individual patient data meta-analysis of quality observational studies to test the following hypotheses: (1) there is a relationship between increasing CMB burden and ICH risk 8,9 ; (2) strictly lobar CMBs (reflecting possible or probable cerebral amyloid angiopathy [CAA]) and mixed or strictly deep CMBs (likely associated with hypertensive arteriopathy) have different effects on ICH risk; (3) CMBs are associated more strongly with the risk of remote ICH than other ICH types 10 ; and (4) CMBs are associated with worse functional outcome. Results-In Methods Study Design and Inclusion CriteriaWe identified prospective or retrospective studies that assessed pretreatment MRI-defined CMBs, ICH, and 3-to 6-month functional outcome after acute ischemic stroke, treated solely with intravenous tPA from a systematic review prepared according to Preferred Reporting Items for Systematic Review and Meta-Analyses 7,11 (updated August 1, 2015). We searched PubMed for micro(-)bleed*, or micro(-)h(a) emorrhag*, or gradient-echo, or susceptibility-weighted in association with thromboly* or tPA, or tissue plasminogen activator 7 ; reference lists; and authors' own files. Figure I in the online-only Data Supplement shows a flow diagram.We collected anonymized individual patient detailed clinical data and CMB counts in lobar, deep, and infratentorial regions according to standardized definitions 6,12,13 using standardized report forms. A prespecified protocol was circulated to collaborators but not published. OutcomesWe defined ICH according to ECASS-2 (European Cooperative Acute Stroke Study II), 14,15 including hemorrhagic infarction, parenchymal hemorrhage (PH), and sICH 16 (acute intracerebral blood and associated increase in National Institutes of Health Stroke Scale ≥4 points, except 1 study 17 that used the definition in the PROACT-II trial [Prolyse in Acute Cerebral Thromboembolism]).18 Remote parenchymal hemorrhage (PHr) was defined as ICH remote from the symptomatic ischemic area. 10 We defined poor outcome at 3 to 6 months as modified...

This article represents the recommendations for the management of spontaneous intracerebral haemorrhage of the European Stroke Initiative (EUSI). These recommendations are endorsed by the 3 European societies which are represented in the EUSI: the European Stroke Council, the European Neurological Society and the European Federation of Neurological Societies.

Diffuse thyroidal FDG uptake may be an indicator of chronic thyroiditis. The actual prevalence of the disorder was not low in this series, and such lesions may be found incidentally at FDG PET.

Summary Whole-body positron emission tomography (PET) with 18 F-fluorodeoxyglucose (FDG) is a diagnostic modality that can noninvasively survey the entire body and sensitively detect various cancers. In this study, we examined the potential application of whole-body PET for cancer screening in asymptomatic individuals. PET was performed in conjunction with conventional examinations including physical examination, laboratory study, ultrasonography and chest computed tomography. Between September 1994 and March 1999, 3165 asymptomatic individuals participated in 5575 screening sessions (2017 men and 1148 women; mean ± SD age, 52.2 ± 10.4 years). Followup periods were no less than 10 months. PET results were compared with the screening outcomes. Within 1 year after screening, malignant tumours were discovered in 67 of the 3165 participants (2.1%). PET findings were true-positive in 36 of the 67 cancers (54%). Most of the 36 patients underwent potentially curative surgery; thus a wide variety of cancers were detected by PET at potentially curable stages. However, PET findings were false-negative in 31 of the 67 patients (46%). 14 of these 31 (45%) were of urological origin. FDG PET imaging has the potential to detect a wide variety of cancers at potentially curable stages. However, PET imaging is not suited to screening test of general population because PET examination involves substantial cost.