Neurology: The presence and prognosis of micro-bleeding in the brain is not related to the post-stroke vascular thrombosis

Micro-bleeding of the brain (CMBs) detected by the blood-sensitive MRI sequence corresponds to the deposition of pentothrombosis, which may be caused by previous abnormal leakage of small blood vessels and is a sign of hemorrhagic microvascular disease (SVD).
risk of intracranial haemorrhage (ICH) in stroke patients with venous thrombosis has been linked to the CMB burden, but the benefit-risk ratio of intravenous tissue clotting enzyme primary activator (tPA) is still unclear in patients with this high CMB burden (usually 10 CMB).
addition, the hypoththemary effect of CMB burden on ICH risk after acute ischemic stroke (AIS) vascular thrombosis (EVT) remains unknown.
, Imad Derra of Hôpital Gui de Chauliac, France, et al., explored whether the presence and burden of pre-EVT CMB was associated with clinical outcomes in the three months after ICH and AIS.
also explored the clinical impact of CMBs on successful refill patient outcomes, in which CMBs may have a more significant impact on outcomes.
reviewed patients who continued to receive EVT pre-treatment circulating AIS.
and use a valid scale to rate CMBs on T2-MRI.
also analyzed the relationship between the presence and burden of CMB and adverse clinical outcomes at ICH and 3 months (mRankin score.
results showed poor results for 281 (54.8%) out of 513 patients and 89 (17.3%) for CMBs ≥1.
190 (37%) patients had ICH, of whom 66 (12.9%) had symptoms.
In a single-variable analysis, the CMB burden was associated with adverse outcomes (OR1.18; P=0.02), but lost significantity (OR1.05; P=0.50) after adjusting for sex, age, stroke severity, hypertension, diabetes, atrial fibrillation, past anti-thrombosis drugs, venous thrombosis, and refilling states.
the results were not significant when the location of CMB or the presumed underlying pathogenesis was taken into account.
the presence, burden, location, and hypothetical pathogenesis of CMB are independently associated with ICH.
the significance of this study is that there is no basis for excluding such patients from refill therapy because of the presence or burden of CMB for pre-EVT MRIs after a stroke, which is not related to poor functional outcomes or ICH.
original source: Microbleeds, Cerebral Hemorrhage, and Functional Outcome Endovascular Thrombectomy; Imad Derraz; et al. Neurology Jan 2021, 10.1212/WNL.0000000000011566; DOI: 10.1212/WNL.0000000000011566 Freeman Source: MedSci Original Copyright Notice: All noted on this website "Source: Mets Medicine" or "Source: MedSci Original" text, images and audio and video materials, copyrights are owned by Metz Medicine, without authorization, no media, website or individual may reproduce, authorized to reproduce with the words "Source: Mets Medicine".
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