急性缺血性卒中静脉溶栓后远隔部位脑出血的临床特征和预后分析

目的 探讨急性缺血性卒中静脉溶栓后发生远隔部位脑出血(remote parenchymal hemorrhage,rPH)的临床特征和预后.方法 回顾性分析2016年1月-2020年4月在长沙市中心医院静脉溶栓后发生rPH患者的资料,探讨rPH的临床及影像学特征以及90?d时功能预后(良好预后定义为mRS<2分).结果...

Clinical Features and Prognosis of Remote Parenchymal Hemorrhage after Intravenous Thrombolysis in Acute Ischemic Stroke

Objective To investigate the clinical features and prognosis of remote parenchymal hemorrhage(rPH) after intravenous thrombolysis in acute ischemic stroke.Methods A retrospective analysis of patients with rPH after intravenous thrombolysis fromChangsha Central Hospital between January 2016 and April 2020 was performed. The clinicalfeatures, imaging characteristics and 90-day functional outcome (a favorable outcome was definedas mRS score <2 at 90 days) of patients with rPH were analyzed.Results A total of 376 patients received intravenous thrombolysis, and hemorrhagic transformation(HT) occurred in 31 patients (8.2%), including 10 patients with rPH. The incidence of rPH in allthrombolysis patients was 2.7%, and 32.3% in all HT patients. For 10 rPH patients, 9 cases (90.0%)were men, the mean age was 69.5±8.6 years, the baseline NIHSS score before thrombolysis was4.5 (3~9). 6 rPH patients had old ischemic lesions on CT scan before thrombolysis; 5 rPH patientshad moderate to severe leukoaraiosis on MR FLAIR imaging; severe stenosis at the initial segmentof internal carotid artery contralateral to the bleeding lesions were observed in 2 rPH patients; thefibrinogen concentration after thrombolysis reduced significantly in 2 rPH patients. 8 patients hadlobar rPH, and 2 patients had deep rPH. There were 6 rPH cases with bleeding <5 mL, 2 rPH cases