Cortical Superficial Siderosis and Risk of Bleeding after Thrombolysis for Ischemic Stroke

Cerebrovascular Diseases
Thomas GattringerChristian Enzinger

Abstract

Cortical superficial siderosis (CSS) is a neuroimaging marker of cerebral amyloid angiopathy and has been associated with a high risk for early subsequent major intracranial hemorrhage (ICH). Therefore, many experts recommend withholding of antithrombotic medication to patients with CSS. In this study, we sought to investigate the prevalence of CSS and the associated risk of ICH in the setting of intravenous thrombolysis (IVT) for ischemic stroke. We retrospectively searched the medical documentation system of our primary and tertiary care university clinic for all patients with ischemic stroke that received IVT from 2009 to December 2014. All available imaging data were reviewed in a standardized manner and blinded to any clinical data for the presence of CSS and ICH. CSS was defined as linear signal loss along the cerebral cortex on gradient echo T2*-weighted sequences. A stroke neurologist, who was blinded to the neuroimaging data, extracted the corresponding clinical data including follow-up information. We identified 298 patients that received IVT and had undergone brain MRI (mean age 67.6 ± 12.6 years, 59.4% male). Cerebral MRI was performed in 116 patients (38.9%) before and in 182 patients (61.1%) after IVT (median time...Continue Reading

Citations

Feb 4, 2016·Journal of Thrombosis and Thrombolysis·Josef G Heckmann
Jun 8, 2018·Current Opinion in Neurology·Franz FazekasChristian Enzinger
Jul 14, 2016·Stroke; a Journal of Cerebral Circulation·Luis Prats-SánchezUNKNOWN Catalan Stroke Code and Reperfusion Consortium (Cat-SCR)
Feb 6, 2020·Journal of Neurology, Neurosurgery, and Psychiatry·François CaparrosDidier Leys

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