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Chapter 20 - Cerebral microbleeds and thrombolysis

from Section 3 - Microbleeds in relation to specific populations, diseases and neurological symptoms

Published online by Cambridge University Press:  05 July 2011

David J. Werring
Affiliation:
Institute of Neurology, London
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Summary

Thrombolytic therapy is the only treatment for acute ischemic stroke proven to improve clinical outcome. Identifying patients at higher risk for hemorrhagic transformation following thrombolysis is an important goal, and this information could increase the overall safety profile of thrombolytic therapy. The most comprehensive and informative data on the risk of thrombolysis-induced hemorrhage in the setting of cerebral microbleeds (CMBs) and acute stroke comes from the Bleeding Risk Analysis in Stroke Imaging before thrombolysis (BRASIL) study. In cerebral amyloid angiopathy (CAA), CMBs are located predominantly in lobar regions and the total number of lesions is often significant (10-75 or more). A lobar location is also a more common site for thrombolysis-related hemorrhages. In contrast, CMBs linked to hypertensive small vessel disease are typically located in predominantly deep regions and may be far fewer in number.
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Cerebral Microbleeds
Pathophysiology to Clinical Practice
, pp. 173 - 177
Publisher: Cambridge University Press
Print publication year: 2011

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