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MRI May Predict tPA-Linked Hemorrhage Risk After Stroke

Researchers recommend screening for parenchymal enhancement, hyperintensity MCA sign

TUESDAY, May 2 (HealthDay News) -- Ischemic stroke patients who have parenchymal enhancement and hyperintensity MCA sign on magnetic resonance imaging (MRI) may be at a higher risk of developing hemorrhagic complications following treatment with intravenous tissue plasminogen activator (tPA), according to research presented this week at the annual meeting of the American Roentgen Ray Society in Vancouver, Canada.

Gang Guo, M.D., of the Shantou University Medical College in Guangdong, China, and colleagues analyzed the MRIs of 24 ischemic stroke patients, 10 of whom developed hemorrhagic complications. The patients had the MRIs within about five hours of symptom onset, and the researchers retrospectively reviewed the results.

In six of the 10 patients with hemorrhagic complications, the researchers found signs of parenchymal enhancement. They also found hyperintensity MCA sign in five of the 10 patients. They found neither result in the 14 patients who did not develop hemorrhagic complications.

"The risk of life-threatening hemorrhaging increases 10-fold after intravenous tPA, so the ability to identify patients at increased risk for secondary bleeding after acute stroke could potentially be helpful in increasing the effectiveness and safety of the therapy," Guo said in a statement. "We recommend that acute stroke imaging protocols that usually include gadolinium administration be followed with T1-weighted spin-echo MRI to screen for parenchymal enhancement and the hyperintense MCA sign."

Abstract (#054)

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