前循环急性缺血性卒中患者血运重建术后脑实质内血肿类型作为预测指标
Types of intraparenchymal hematoma as a predictor after revascularization in patients with anterior circulation acute ischemic stroke.
作者信息
Morinaga Yusuke, Nii Kouhei, Takemura Yusuke, Hanada Hayatsura, Sakamoto Kimiya, Hirata Yoko, Inoue Ritsurou, Tsugawa Jun, Kimura Satoshi, Kurihara Kanako, Tateishi Yuji, Higashi Toshio
机构信息
Department of Neurosurgery, Fukuoka University, Chikushi Hospital, Chikushino, Fukuoka, Japan.
Stroke Center, Fukuoka University, Chikushi Hospital, Chikushino, Fukuoka, Japan.
出版信息
Surg Neurol Int. 2021 Mar 17;12:102. doi: 10.25259/SNI_792_2020. eCollection 2021.
BACKGROUND
Intracranial hemorrhage after revascularization for acute ischemic stroke is associated with poor outcomes. Few reports have examined the relationship between parenchymal hematoma after revascularization and clinical outcomes. This retrospective study aimed to investigate the risk factors and clinical outcomes of parenchymal hematoma after revascularization for acute ischemic stroke.
METHODS
Ninety-three patients underwent revascularization for anterior circulation acute ischemic stroke. Patient characteristics and clinical outcomes were compared between patients with and without post procedural parenchymal hematoma using the following parameters: age, sex, occlusion location, presence of atrial fibrillation, diffusion-weighted imaging-Alberta stroke program early computed tomography score (DWI-ASPECTS), National Institute of Health Stroke Scale (NIHSS) score, recombinant tissue plasminogen activator, thrombolysis in cerebral infarction > 2b, door-to-puncture time, onset-to-recanalization time, number of passes, and modified Rankin Scale scores.
RESULTS
Parenchymal hematomas were not significantly correlated with age, sex, occlusion location, atrial fibrillation, DWI-ASPECTS, NIHSS score, recombinant tissue plasminogen activator, thrombolysis in cerebral infarction > 2b, door-to-puncture time, onset-to-recanalization time, and number of passes, but were significantly correlated with poor clinical outcomes ( = 0.001) and absence of the anterior communicating artery evaluated using pre procedural time-of-flight magnetic resonance angiography ( = 0.03).
CONCLUSION
Parenchymal hematoma was a predictor of poor outcomes. In particular, the absence of the anterior communicating artery on pre procedural time-of-flight magnetic resonance angiography is a potential risk factor for parenchymal hematoma after revascularization for anterior circulation acute ischemic stroke.
背景
急性缺血性卒中血管重建术后颅内出血与预后不良相关。很少有报告研究血管重建术后脑实质血肿与临床结局之间的关系。这项回顾性研究旨在调查急性缺血性卒中血管重建术后脑实质血肿的危险因素和临床结局。
方法
93例患者接受了前循环急性缺血性卒中的血管重建治疗。使用以下参数比较有和没有术后脑实质血肿的患者的特征和临床结局：年龄、性别、闭塞部位、房颤的存在、弥散加权成像-阿尔伯塔卒中项目早期计算机断层扫描评分（DWI-ASPECTS）、美国国立卫生研究院卒中量表（NIHSS）评分、重组组织型纤溶酶原激活剂、脑梗死溶栓>2b、门到穿刺时间、发病到再通时间、穿刺次数和改良Rankin量表评分。
结果
脑实质血肿与年龄、性别、闭塞部位、房颤、DWI-ASPECTS、NIHSS评分、重组组织型纤溶酶原激活剂、脑梗死溶栓>2b、门到穿刺时间、发病到再通时间和穿刺次数无显著相关性，但与不良临床结局显著相关（P = 0.001），并且与术前使用飞行时间磁共振血管造影评估的前交通动脉缺如显著相关（P = 0.03）。
结论
脑实质血肿是预后不良的预测指标。特别是，术前飞行时间磁共振血管造影显示前交通动脉缺如是前循环急性缺血性卒中血管重建术后脑实质血肿的潜在危险因素。
Zotero 插件