More extensive white matter hyperintensity is linked with higher risk of remote intracerebral hemorrhage after intravenous thrombolysis

Chen, Y.; Yan, Shiyu; Xu, Maochao; Zhong, Genlong; Liebeskind, David S; Lou, Min

doi:10.1111/ene.13517

Cited by 22 publications

(14 citation statements)

References 34 publications

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“…This may account for why our sICH incidence was lower than theirs. Our results about the relationship of LA and HT were consistent with other existing studies [ 26 – 28 ], but the proportion of severe LA (35.9%) from France [ 28 ] was higher than ours (26.4%). There are two explanations for this difference: first, their sample consisted of an older population (aged over 75 years) than ours, and second, their imaging assessments were based on MRI, through which the detection rate of LA may be higher than our based on brain CT because of sensitivity [ 29 ].…”

Section: Discussionsupporting

confidence: 92%

The relationship of leukoaraiosis, haemorrhagic transformation and prognosis at 3 months after intravenous thrombolysis in elderly patients aged ≥ 60 years with acute cerebral infarction

et al. 2020

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Backgroud As the elderly stroke population continues to increase, we will have to confront greater challenges regarding how to choose suitable patients to reduce thrombolysis-related bleeding events and accurately judge their prognosis. Therefore, we evaluated the relationship among leukoaraiosis (LA), haemorrhagic transformation (HT) and the prognosis at 3 months after intravenous (IV) thrombolysis in elderly patients aged ≥ 60 years with acute cerebral infarction (ACI). Methods We prospectively and consecutively chose 125 elderly patients aged ≥ 60 years with ACI who could accept and be suitable for IV recombinant tissue plasminogen activator (rtPA) after excluding 6 cases. Brain computed tomography(CT) was used to assess LA by using the modified Van Swieten scale (mVSS) before treatment and the modified Rankin scale (mRS) to appraise prognosis at 3 months after IV rtPA. Binary logistic regression was used to analyse the predictors of HT and the prognosis of ACI. Results Our data indicated that by brain CT, 26.4% of all patients showed severe LA, and the rate of HT and symptomatic intracranial haemorrhage (sICH) were 12.0% and 9.6%, respectively. Severe LA was evidently associated with HT (odds ratio [OR] 3.272, 95% confidence interval [CI] 1.010–10.598, P = 0.048) rather sICH (P > 0.05). Moreover, we also found that severe LA was associated with poor functional prognosis (OR 5.266, 95% CI 1.592–17.419, P = 0.006). Conclusion Our results showed that LA was associated with HT and adverse clinical prognosis rather sICH after IV rtPA in elderly patients aged ≥60 years with ACI. Although LA may increase the risk of bleeding but not fatal haemorrhage after IV thrombolysis, therefore, we should actively select an appropriate elderly population for thrombolytic treatment and have reasonable judgments on the outcomes.

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Section: Discussionsupporting

confidence: 92%

The relationship of leukoaraiosis, haemorrhagic transformation and prognosis at 3 months after intravenous thrombolysis in elderly patients aged ≥ 60 years with acute cerebral infarction

et al. 2020

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“…Several examples from the related literature have demonstrated that severe WMH had an impact on larger ICH volumes and hematoma growth; moreover, progression of WMH was an independent predictor of worse functional outcomes in patients with ICH (Lou et al, 2010; Caprio et al, 2013). Our recent research has also shown that greater severity and progression of WMH resulted in larger ICH volumes at baseline (Chen et al, 2018). Therefore, the progression of WMH is an important factor in determining the prognosis of patients with ICH.…”

Section: Introductionmentioning

confidence: 79%

“…Interestingly, the relationship between ICH and WMH progression is a mutually promoting process, not merely a unilateral process. Recent studies have shown that severe WMH was associated with spontaneous lobar hemorrhage and a greater risk of local hemorrhage after intravenous thrombolysis (IVT; Chen et al, 2018). In addition, more extensive WM damage was detected in patients with ICH than in those with ischemic stroke or other cerebral small vessel pathologies (Rost et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

The Impact of Intracerebral Hemorrhage on the Progression of White Matter Hyperintensity

Chen

et al. 2018

Front. Hum. Neurosci.

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Objective: The exact relationship between white matter hyperintensity (WMH) and intracerebral hemorrhage (ICH) after ICH remains unclear. In this retrospective study, we investigated whether patients with ICH had more severe WMH progression.Patients and Methods: A total of 2,951 patients aged ≥40 years with ICH who received brain computed tomography (CT) imaging within 12 h of ICH symptom onset were screened. Ninety patients with two fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging (MRI) assessments, including 36 patients with Lobar ICH, 40 with basal ganglia region ICH and 14 with ICH at other sites, were included in the final study. We selected 90 age- and gender-matched healthy individuals with two MRI scans as the control group. The WMH volumes at baseline and follow-up were assessed using the FLAIR image by MRICRON and ITK-SNAP software, while the hematoma volumes were calculated based on the CT images using ITK-SNAP software.Results: The annual progression rate of WMH was significantly higher in the ICH group compared with the control group (p < 0.05). Furthermore, WMH progression was associated with the ICH volume. The largest ICH volume (>30 mL) was associated with the highest annual progression rate of WMH (p < 0.05). In contrast, no trend toward an association between ICH location and the annual progression rate of WMH was observed (p > 0.05).Conclusions: Our results showed that ICH patients had more severe WMH progression and that larger ICH volume was related to greater progression of WMH after ICH. These results could provide important prognostic information about patients with ICH.

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“…Eq. (10) gives the time-scale taking into account the Sun gravity (Chen & Lykoudis 1972). Within the set of our framework parameters t KH−RT ∼ 3 × 10 3 s, thus the conduction terms will diffuse the structures formed by these type of instabilities, making them unlikely detectable as SADs.…”

Section: The Modelmentioning

confidence: 99%

MHD Simulations of Coronal Supra-Arcade Downflows Including Anisotropic Thermal Conduction

Zurbriggen

Costa

Esquivel

et al. 2016

ApJ

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Coronal supra-arcade downflows (SADs) are observed as dark trails descending towards hot turbulent fan shaped regions. Due to the large temperature values, and gradients in these fan regions the thermal conduction should be very efficient. While several models have been proposed to explain the triggering and the evolution of SADs, none of these scenarios address a systematic consideration of thermal conduction. Thus, we accomplish this task numerically simulating the evolution of SADs within this framework. That is, SADs are conceived as voided (subdense) cavities formed by nonlinear waves triggered by downflowing bursty localized reconnection events in a perturbed hot fan. We generate a properly turbulent fan, obtained by a stirring force that permits control of the energy and vorticity input in the medium where SADs develop. We include anisotropic thermal conduction and consider plasma properties consistent with observations. Our aim is to study if it is possible to prevent SADs to vanish by thermal diffusion. We find that this will be the case, depending on the turbulence parameters. In particular, if the magnetic field lines are able to envelope the voided cavities, thermally isolating them from the hot environment. Velocity shear perturbations that are able to generate instabilities of the Kelvin-Helmholtz type help to produce magnetic islands, extending the life-time of SADs.

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More extensive white matter hyperintensity is linked with higher risk of remote intracerebral hemorrhage after intravenous thrombolysis

Abstract: An increased occurrence rate of rICH after IVT is related to more extensive WMH, which may suggest underlying whole-brain vascular injury in patients with WMH.

Cited by 22 publications

References 34 publications

The relationship of leukoaraiosis, haemorrhagic transformation and prognosis at 3 months after intravenous thrombolysis in elderly patients aged ≥ 60 years with acute cerebral infarction

The relationship of leukoaraiosis, haemorrhagic transformation and prognosis at 3 months after intravenous thrombolysis in elderly patients aged ≥ 60 years with acute cerebral infarction

The Impact of Intracerebral Hemorrhage on the Progression of White Matter Hyperintensity

MHD Simulations of Coronal Supra-Arcade Downflows Including Anisotropic Thermal Conduction

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