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Detection and Significance of Incidental Unruptured Cerebral Aneurysms in Patients Undergoing Intravenous Thrombolysis for Acute Ischemic Stroke
Author(s) -
Kim JoonTae,
Park ManSeok,
Yoon Woong,
Cho KiHyun
Publication year - 2012
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/j.1552-6569.2010.00560.x
Subject(s) - medicine , thrombolysis , angiography , intracerebral hemorrhage , aneurysm , stroke (engine) , radiology , cerebral angiography , cerebral infarction , surgery , ischemia , subarachnoid hemorrhage , myocardial infarction , mechanical engineering , engineering
BACKGROUND It is still controversial whether intravenous (IV) thrombolysis for acute ischemic stroke increases the risk of aneurysmal bleeding. We sought to find the risk for aneurysmal bleeding after IV thrombolysis in ischemic stroke patients with unruptured cerebral aneurysms. METHODS We retrospectively analyzed consecutive patients with acute ischemic stroke who had received IVT between August 2006 and November 2009. Immediately after IV‐tissue plasminogen activator (tPA) therapy (.9 mg/kg), patients underwent CT angiography, MR angiography. After that, all patients underwent follow‐up angiography within 36 hours of the initiation of IV thrombolysis. Aneurysm‐related hemorrhage was defined as a hemorrhage that was related to the aneurysm site. RESULTS A total of 201 patients were analyzed, and 8 (4.1%) had unruptured cerebral aneurysms. Of the 8 patients, 4 had aneurysms over 5 mm of the longest diameter. Three patients had intracerebral hemorrhage that developed at the site of infarction, which was unrelated to the aneurysms. CONCLUSION The results of this study suggest that IV thrombolysis might not increase the risk of aneurysmal bleeding in acute stroke patients with unruptured aneurysm < 10 mm in diameter. Further studies with a larger sample size are needed to confirm our result. J Neuroimaging 2012;22:197‐200