White matter lesions and intra-arterial thrombolysis.

Publication

White matter lesions and intra-arterial thrombolysis.

Journal Paper/Review - Jan 17, 2012

Jung Simon, Mono Marie-Luise, Findling Oliver, Fischer Urs, Galimanis Aekaterini, Weck Anja, De Marchis Gian Marco, Ballinari Pietro, Gralla Jan, Brekenfeld Caspar, Schroth Gerhard, Arnold Marcel, Mattle Heinrich Paul, El-Koussy Marwan

Citation

Jung S, Mono M, Findling O, Fischer U, Galimanis A, Weck A, De Marchis G, Ballinari P, Gralla J, Brekenfeld C, Schroth G, Arnold M, Mattle H, El-Koussy M. White matter lesions and intra-arterial thrombolysis. J Neurol 2012; 259:1331-6.

Type

Journal Paper/Review (English)

Journal

J Neurol 2012; 259

Publication Date

Jan 17, 2012

Issn Electronic

1432-1459

Pages

1331-6

Brief description/objective

The aim of the study was to assess the influence of white matter lesions in patients with acute ischemic stroke treated with intra-arterial thrombolysis (IAT). From September 2003 to January 2010, we treated 400 patients with IAT at our institution. Of these patients, 292 were evaluated with MRI scans and included in this observational study. Clinical data were collected prospectively. Outcome after 3 months was measured with the modified Rankin Scale (mRS); mRS 0-1 was considered as favorable outcome. White matter lesions were scored visually by two observers using the semiquantitative Scheltens and Fazekas scores. Logistic regression analysis was used to identify the association of white matter lesions and clinical outcome, recanalization, and cerebral hemorrhage. The severity of white matter lesions was inversely correlated with favorable outcome, survival and successful recanalization. White matter lesions were an independent predictor of outcome (OR 0.569, p = 0.007) and survival (OR 0.550, p = 0.018) and a weak but independent predictor for recanalization (OR 0.949, p = 0.038). Asymptomatic intracerebral bleeding after IAT was associated with white matter lesions in the basal ganglia in the univariate analysis (p = 0.036), but not after multivariable analysis. The severity of white matter lesions independently predicts clinical outcome and survival in patients treated with IAT. White matter lesions are also a weak but independent predictor for recanalization. Symptomatic intracranial bleeding after IAT are not associated with white matter lesions. Therefore, white matter lesions should not be considered as a contraindication against IAT.