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Cerebral Microbleeds and Functional Outcomes after Ischemic Stroke

  • Tae-Won Kim (a1), Seung-Jae Lee (a2), Jaseong Koo (a1), Hyun-Seok Choi (a3), Jeong-Wook Park (a1), Kwang-Soo Lee (a1) and Joong-Seok Kim (a1)...

Abstract

Background

Whether an association exists between cerebral microbleeds (CMBs) and functional recovery after ischemic stroke is unclear. We aimed to evaluate the association between CMBs and functional outcome after acute ischemic stroke.

Methods

Consecutive patients with acute stroke were enrolled, and all patients were stratified into good and poor functional outcome groups at discharge and 6 months after ischemic stroke by using a modified Rankin Scale score. Cardiovascular risk factors, CMBs, and white matter hyperintensities were compared between these two outcome groups. Logistic regression analysis was used to estimate the risk of poor functional outcomes.

Results

A total of 225 patients were enrolled, 121 of whom were classified as having a good functional outcome at discharge and 142 as having a good 6-month functional outcome. The presence of CMBs was associated with a poor functional outcome at discharge [CMBs (+) patients in poor vs. good functional group; 48.1% vs. 30.6%; p=0.007] and 6 months [53.0% vs. 30.3%; p=0.001]. After adjustment for confounding factors, only the presence of infratentorial CMBs was associated with a poor functional outcome at discharge and 6 months. The poor functional outcome group had more CMBs than the good outcome group at 6 months.

Conclusions

Infratentorial cerebral microbleeds were significantly associated with worse functional outcomes not only in the early phase of ischemic stroke but also in the chronic phase. These findings suggest that the presence of infratentorial CMBs can predict poor functional outcome after acute ischemic stroke.

Contexte

On ne sait pas s’il existe une association entre les microsaignements cérébraux (MSC) et la récupération fonctionnelle après un accident vasculaire cérébral ischémique (AVCI). Le but de l’étude était d’évaluer l’association entre les MSC et l’issue fonctionnelle après un AVCI.

Méthode

L’étude a porté sur des patients consécutifs admis pour un AVC aigu. Ils ont été séparés en deux groupes, selon que l’issue clinique fonctionnelle, évaluée au moyen de l’échelle modifiée de Rankin, était bonne ou mauvaise au moment du congé hospitalier et 6 mois après l’AVCI. Les facteurs de risque cardiovasculaire, les MSC et les zones d’hyperintensité ont été comparés entre les deux groupes. L’analyse de régression logistique a été utilisée pour estimer le risque que l’issue fonctionnelle soit mauvaise.

Résultats

Deux cent vingt-cinq patients ont été admis à l’étude dont 121 ont été classifiés dans le groupe dont l’issue fonctionnelle était favorable au moment du congé hospitalier et 142 dans le groupe dont l’une issue fonctionnelle était favorable 6 mois après l’AVCI. La présence de MSC était associée à un résultat fonctionnel défavorable au moment du congé hospitalier [patients MSC (+) dans le groupe ayant une issue fonctionnelle défavorable par rapport à ceux dont l’issue fonctionnelle était favorable : 48,1% par rapport à 30,6% ; p = 0,007] et à 6 mois [53,0% par rapport à 30,3% ; p = 0,001]. Après correction pour les facteurs de confusion, seule la présence de MSC sous-tentoriels était associée à une issue fonctionnelle défavorable au moment du congé hospitalier et 6 mois après l’AVC. Le groupe de patients dont l’issue fonctionnelle était défavorable avaient plus de MSC que le groupe dont l’issue était favorable 6 mois après l’AVC.

Conclusions

Les MSC sous-tentoriels étaient associés de façon significative à une issue fonctionnelle moins bonne, non seulement au cours de la phase précoce de mais aussi au cours de la phase chronique de l’AVCI. La présence de MSC sous-tentoriels pourrait prédire une issue fonctionnelle défavorable après un AVCI.

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Copyright

Corresponding author

Correspondence to: Joong-Seok Kim, Department of Neurology, Seoul St. Mary’s Hospital, Catholic University of Korea, Seocho-gu, Seoul 137-701, Korea. Email: neuronet@catholic.ac.kr.

References

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