Advanced imaging improves prediction of hemorrhage after stroke thrombolysis

BCV Campbell; S Christensen; MW Parsons; L Churilov; PM Desmond; PA Barber; KS Butcher; CR Levi; DA De Silva; MG Lansberg; M Mlynash; JM Olivot; M Straka; R Bammer; GW Albers; GA Donnan; SM Davis

Journal article

Advanced imaging improves prediction of hemorrhage after stroke thrombolysis

BCV Campbell, S Christensen, MW Parsons, L Churilov, PM Desmond, PA Barber, KS Butcher, CR Levi, DA De Silva, MG Lansberg, M Mlynash, JM Olivot, M Straka, R Bammer, GW Albers, GA Donnan, SM Davis

Annals of Neurology | WILEY-BLACKWELL | Published : 2013

DOI: 10.1002/ana.23837

Abstract

Objective: Very low cerebral blood volume (VLCBV), diffusion, and hypoperfusion lesion volumes have been proposed as predictors of hemorrhagic transformation following stroke thrombolysis. We aimed to compare these parameters, validate VLCBV in an independent cohort using DEFUSE study data, and investigate the interaction of VLCBV with regional reperfusion. Methods The EPITHET and DEFUSE studies obtained diffusion and perfusion magnetic resonance imaging (MRI) in patients 3 to 6 hours from onset of ischemic stroke. EPITHET randomized patients to tissue plasminogen activator (tPA) or placebo, and all DEFUSE patients received tPA. VLCBV was defined as cerebral blood volume2 ml VLCBV threshold ..

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University of Melbourne Researchers

Bruce Campbell Author

Leonid Churilov Author

Patricia Desmond Author

Geoffrey Donnan Author

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Grants

Awarded by National Institute of Neurological Disorders and Stroke

Funding Acknowledgements

[ "The EPITHET study was supported by the National Health and Medical Research Council (NHMRC) of Australia, National Stroke Foundation, and National Heart Foundation of Australia.", "The DEFUSE study was funded by NIH grants RO1 NS39325 R01 NS39325/NS/NINDS NIH HHS/United States (principal investigator [PI], G.W.A.), K24 NS044848 K24 NS044848/NS/NINDS NIH HHS/United States (PI, G. W. A.), and K23 NS051372 K23 NS051372/NS/NINDS NIH HHS/United States (PI, M.G.L.). tPA was supplied at no charge by Boehringer Ingelheim (Australia, New Zealand, and Europe) and Genentech (USA and Canada). Neither Boehringer Ingelheim, Genentech, nor the NIH played a role in the design and the conduct of the studies; collection, management, analysis, and interpretation of the data; or preparation or approval of the manuscript.", "B.C.V.C. receives research support from the NHMRC of Australia (Early Career Fellowship 1035688 and Postgraduate Scholarship 567156), the Heart Foundation of Australia, a Cardiovascular Lipid Australia grant, and the Neuroscience Foundation of the Royal Melbourne Hospital. R.B. receives support from NIH grant R01 EB002711 R01 EB002711-05/EB/NIBIB NIH HHS/United States." ]