Very low cerebral blood volume predicts parenchymal hematoma in acute ischemic stroke

Laure Hermitte; Tae-Hee Cho; Brice Ozenne; Norbert Nighoghossian; Irene Klærke Mikkelsen; Lars Ribe; Jean-Claude Baron; Leif Østergaard; Laurent Derex; Niels Hjort; Jens Fiehler; Salvador Pedraza; Marc Hermier; Delphine Maucort-Boulch; Yves Berthezène

doi:10.1161/strokeaha.113.001751

Very low cerebral blood volume predicts parenchymal hematoma in acute ischemic stroke

Laure Hermitte, Tae-Hee Cho, Brice Ozenne, Norbert Nighoghossian, Irene Klærke Mikkelsen, Lars Ribe, Jean-Claude Baron, Leif Østergaard, Laurent Derex, Niels Hjort, Jens Fiehler, Salvador Pedraza, Marc Hermier, Delphine Maucort-Boulch, Yves Berthezène

Section of Biostatistics

28 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: Parenchymal hematoma (PH) may worsen the outcome of patients with stroke. The aim of our study was to confirm the relationship between the volume of very low cerebral blood volume (CBV) and PH using a European multicenter database (I-KNOW). A secondary objective was to explore the impact of early reperfusion and recanalization.

METHODS: The volume of cerebral tissue with CBV≤2.5th percentile of the normal hemisphere was calculated within the acute diffusion-weighted imaging lesion. Hemorrhagic transformation was assessed on day 2 MRI according to the European Cooperative Acute Stroke Study II criteria. Recanalization and reperfusion were assessed on 3-hour follow-up MRI.

RESULTS: Of the 110 patients, hemorrhagic transformation occurred in 59 patients, including 7 PH. In univariate analysis, the acute National Institutes of Health Stroke Scale score (P=0.002), acute diffusion-weighted imaging lesion volume (P=0.02), and thrombolysis (P=0.03), but not very low CBV (P=0.52), were associated with hemorrhagic transformation. The volume of very low CBV was the only predictor of PH (P=0.007). Early reperfusion and recanalization had no influence on either hemorrhagic transformation or PH.

CONCLUSION: Very low CBV was the only independent predictor of PH in patients with acute stroke.

Original language	English
Journal	Stroke
Volume	44
Issue number	8
Pages (from-to)	2318-20
Number of pages	3
ISSN	0039-2499
DOIs	https://doi.org/10.1161/strokeaha.113.001751
Publication status	Published - Aug 2013

Keywords

Acute Disease
Aged
Aged, 80 and over
Blood Volume
Brain Ischemia
Cerebrovascular Circulation
Cohort Studies
Diffusion Magnetic Resonance Imaging
Europe
Female
Hematoma
Humans
Male
Middle Aged
Predictive Value of Tests
Registries
Reperfusion
Severity of Illness Index
Stroke
Time Factors
Treatment Outcome
Journal Article
Research Support, Non-U.S. Gov't

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10.1161/strokeaha.113.001751

STROKEAHA.113.001751Final published version, 321 KB

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Hermitte, L., Cho, T-H., Ozenne, B., Nighoghossian, N., Mikkelsen, I. K., Ribe, L., Baron, J-C., Østergaard, L., Derex, L., Hjort, N., Fiehler, J., Pedraza, S., Hermier, M., Maucort-Boulch, D., & Berthezène, Y. (2013). Very low cerebral blood volume predicts parenchymal hematoma in acute ischemic stroke. Stroke, 44(8), 2318-20. https://doi.org/10.1161/strokeaha.113.001751

Hermitte, L, Cho, T-H, Ozenne, B, Nighoghossian, N, Mikkelsen, IK, Ribe, L, Baron, J-C, Østergaard, L, Derex, L, Hjort, N, Fiehler, J, Pedraza, S, Hermier, M, Maucort-Boulch, D & Berthezène, Y 2013, 'Very low cerebral blood volume predicts parenchymal hematoma in acute ischemic stroke', Stroke, vol. 44, no. 8, pp. 2318-20. https://doi.org/10.1161/strokeaha.113.001751

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title = "Very low cerebral blood volume predicts parenchymal hematoma in acute ischemic stroke",

abstract = "BACKGROUND AND PURPOSE: Parenchymal hematoma (PH) may worsen the outcome of patients with stroke. The aim of our study was to confirm the relationship between the volume of very low cerebral blood volume (CBV) and PH using a European multicenter database (I-KNOW). A secondary objective was to explore the impact of early reperfusion and recanalization.METHODS: The volume of cerebral tissue with CBV≤2.5th percentile of the normal hemisphere was calculated within the acute diffusion-weighted imaging lesion. Hemorrhagic transformation was assessed on day 2 MRI according to the European Cooperative Acute Stroke Study II criteria. Recanalization and reperfusion were assessed on 3-hour follow-up MRI.RESULTS: Of the 110 patients, hemorrhagic transformation occurred in 59 patients, including 7 PH. In univariate analysis, the acute National Institutes of Health Stroke Scale score (P=0.002), acute diffusion-weighted imaging lesion volume (P=0.02), and thrombolysis (P=0.03), but not very low CBV (P=0.52), were associated with hemorrhagic transformation. The volume of very low CBV was the only predictor of PH (P=0.007). Early reperfusion and recanalization had no influence on either hemorrhagic transformation or PH.CONCLUSION: Very low CBV was the only independent predictor of PH in patients with acute stroke.",

keywords = "Acute Disease, Aged, Aged, 80 and over, Blood Volume, Brain Ischemia, Cerebrovascular Circulation, Cohort Studies, Diffusion Magnetic Resonance Imaging, Europe, Female, Hematoma, Humans, Male, Middle Aged, Predictive Value of Tests, Registries, Reperfusion, Severity of Illness Index, Stroke, Time Factors, Treatment Outcome, Journal Article, Research Support, Non-U.S. Gov't",

author = "Laure Hermitte and Tae-Hee Cho and Brice Ozenne and Norbert Nighoghossian and Mikkelsen, {Irene Kl{\ae}rke} and Lars Ribe and Jean-Claude Baron and Leif {\O}stergaard and Laurent Derex and Niels Hjort and Jens Fiehler and Salvador Pedraza and Marc Hermier and Delphine Maucort-Boulch and Yves Berthez{\`e}ne",

year = "2013",

month = aug,

doi = "10.1161/strokeaha.113.001751",

language = "English",

volume = "44",

pages = "2318--20",

journal = "Stroke",

issn = "0039-2499",

publisher = "Lippincott Williams & Wilkins",

number = "8",

}

TY - JOUR

T1 - Very low cerebral blood volume predicts parenchymal hematoma in acute ischemic stroke

AU - Hermitte, Laure

AU - Cho, Tae-Hee

AU - Ozenne, Brice

AU - Nighoghossian, Norbert

AU - Mikkelsen, Irene Klærke

AU - Ribe, Lars

AU - Baron, Jean-Claude

AU - Østergaard, Leif

AU - Derex, Laurent

AU - Hjort, Niels

AU - Fiehler, Jens

AU - Pedraza, Salvador

AU - Hermier, Marc

AU - Maucort-Boulch, Delphine

AU - Berthezène, Yves

PY - 2013/8

Y1 - 2013/8

N2 - BACKGROUND AND PURPOSE: Parenchymal hematoma (PH) may worsen the outcome of patients with stroke. The aim of our study was to confirm the relationship between the volume of very low cerebral blood volume (CBV) and PH using a European multicenter database (I-KNOW). A secondary objective was to explore the impact of early reperfusion and recanalization.METHODS: The volume of cerebral tissue with CBV≤2.5th percentile of the normal hemisphere was calculated within the acute diffusion-weighted imaging lesion. Hemorrhagic transformation was assessed on day 2 MRI according to the European Cooperative Acute Stroke Study II criteria. Recanalization and reperfusion were assessed on 3-hour follow-up MRI.RESULTS: Of the 110 patients, hemorrhagic transformation occurred in 59 patients, including 7 PH. In univariate analysis, the acute National Institutes of Health Stroke Scale score (P=0.002), acute diffusion-weighted imaging lesion volume (P=0.02), and thrombolysis (P=0.03), but not very low CBV (P=0.52), were associated with hemorrhagic transformation. The volume of very low CBV was the only predictor of PH (P=0.007). Early reperfusion and recanalization had no influence on either hemorrhagic transformation or PH.CONCLUSION: Very low CBV was the only independent predictor of PH in patients with acute stroke.

AB - BACKGROUND AND PURPOSE: Parenchymal hematoma (PH) may worsen the outcome of patients with stroke. The aim of our study was to confirm the relationship between the volume of very low cerebral blood volume (CBV) and PH using a European multicenter database (I-KNOW). A secondary objective was to explore the impact of early reperfusion and recanalization.METHODS: The volume of cerebral tissue with CBV≤2.5th percentile of the normal hemisphere was calculated within the acute diffusion-weighted imaging lesion. Hemorrhagic transformation was assessed on day 2 MRI according to the European Cooperative Acute Stroke Study II criteria. Recanalization and reperfusion were assessed on 3-hour follow-up MRI.RESULTS: Of the 110 patients, hemorrhagic transformation occurred in 59 patients, including 7 PH. In univariate analysis, the acute National Institutes of Health Stroke Scale score (P=0.002), acute diffusion-weighted imaging lesion volume (P=0.02), and thrombolysis (P=0.03), but not very low CBV (P=0.52), were associated with hemorrhagic transformation. The volume of very low CBV was the only predictor of PH (P=0.007). Early reperfusion and recanalization had no influence on either hemorrhagic transformation or PH.CONCLUSION: Very low CBV was the only independent predictor of PH in patients with acute stroke.

KW - Acute Disease

KW - Aged

KW - Aged, 80 and over

KW - Blood Volume

KW - Brain Ischemia

KW - Cerebrovascular Circulation

KW - Cohort Studies

KW - Diffusion Magnetic Resonance Imaging

KW - Europe

KW - Female

KW - Hematoma

KW - Humans

KW - Male

KW - Middle Aged

KW - Predictive Value of Tests

KW - Registries

KW - Reperfusion

KW - Severity of Illness Index

KW - Stroke

KW - Time Factors

KW - Treatment Outcome

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1161/strokeaha.113.001751

DO - 10.1161/strokeaha.113.001751

M3 - Journal article

C2 - 23723309

SN - 0039-2499

VL - 44

SP - 2318

EP - 2320

JO - Stroke

JF - Stroke

IS - 8

ER -

Very low cerebral blood volume predicts parenchymal hematoma in acute ischemic stroke

Abstract

Keywords

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