Detection and Significance of Incidental Unruptured Cerebral Aneurysms in Patients Undergoing Intravenous Thrombolysis for Acute Ischemic Stroke

Journal of Neuroimaging, 04/20/2012

The results of this study suggest that intravenous (IV) thrombolysis might not increase the risk of aneurysmal bleeding in acute stroke patients with unruptured aneurysm < 10 mm in diameter.

Methods

  • The authors 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.

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