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Relationship of Whi...
Relationship of White Matter Lesions with Intracerebral Hemorrhage Expansion and Functional Outcome : MISTIE II and CLEAR III
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- Hansen, Björn M. (författare)
- Lund University,Lunds universitet,Klinisk strokeforskning,Forskargrupper vid Lunds universitet,Clinical Stroke Research Group,Lund University Research Groups,Skåne University Hospital
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- Ullman, Natalie (författare)
- The Children's Hospital of Philadelphia
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- Muschelli, John (författare)
- Johns Hopkins Bloomberg School of Public Health
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- Norrving, Bo (författare)
- Lund University,Lunds universitet,Klinisk strokeforskning,Forskargrupper vid Lunds universitet,Stroke policy och kvalitetsregisterforskning,Clinical Stroke Research Group,Lund University Research Groups,Stroke policy and quality register research,Skåne University Hospital
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- Dlugash, Rachel (författare)
- Johns Hopkins University
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- Avadhani, Radhika (författare)
- Johns Hopkins University
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- Awad, Issam (författare)
- University of Chicago
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- Zuccarello, Mario (författare)
- University of Cincinnati
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- Ziai, Wendy C. (författare)
- Johns Hopkins University
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- Hanley, Daniel F. (författare)
- Johns Hopkins University
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- Thompson, Richard E. (författare)
- Johns Hopkins Bloomberg School of Public Health
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- Lindgren, Arne (författare)
- Lund University,Lunds universitet,Klinisk strokeforskning,Forskargrupper vid Lunds universitet,Clinical Stroke Research Group,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
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- 2020-02-05
- 2020
- Engelska 9 s.
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Ingår i: Neurocritical Care. - : Springer Science and Business Media LLC. - 1541-6933 .- 1556-0961. ; 33:2, s. 516-524
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Abstract
Ämnesord
Stäng
- Background/Objective: Intracerebral hemorrhage (ICH) patients commonly have concomitant white matter lesions (WML) which may be associated with poor outcome. We studied if WML affects hematoma expansion (HE) and post-stroke functional outcome in a post hoc analysis of patients from randomized controlled trials. Methods: In ICH patients from the clinical trials MISTIE II and CLEAR III, WML grade on diagnostic computed tomography (dCT) scan (dCT, < 24 h after ictus) was assessed using the van Swieten scale (vSS, range 0–4). The primary outcome for HE was > 33% or > 6 mL ICH volume increase from dCT to the last pre-randomization CT (< 72 h of dCT). Secondary HE outcomes were: absolute ICH expansion, > 10.4 mL total clot volume increase, and a subgroup analysis including patients with dCT < 6 h after ictus using the primary HE definition of > 33% or > 6 mL ICH volume increase. Poor functional outcome was assessed at 180 days and defined as modified Rankin Scale (mRS) ≥ 4, with ordinal mRS as a secondary endpoint. Results: Of 635 patients, 55% had WML grade 1–4 at dCT (median 2.2 h from ictus) and 13% had subsequent HE. WML at dCT did not increase the odds for primary or secondary HE endpoints (P ≥ 0.05) after adjustment for ICH volume, intraventricular hemorrhage volume, warfarin/INR > 1.5, ictus to dCT time in hours, age, diabetes mellitus, and thalamic ICH location. WML increased the odds for having poor functional outcome (mRS ≥ 4) in univariate analyses (vSS 4; OR 4.16; 95% CI 2.54–6.83; P < 0.001) which persisted in multivariable analyses after adjustment for HE and other outcome risk factors. Conclusions: Concomitant WML does not increase the odds for HE in patients with ICH but increases the odds for poor functional outcome. Clinical Trial Registration: http://www.clinicaltrials.gov trial-identifers: NCT00224770 and NCT00784134.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Nyckelord
- Cerebral hemorrhage
- Cerebral small vessel diseases
- Leukoaraiosis
- Leukoencephalopathies
- Prognosis
- Stroke
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- art (ämneskategori)
- ref (ämneskategori)
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Hansen, Björn M.
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Ullman, Natalie
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Muschelli, John
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Norrving, Bo
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Dlugash, Rachel
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Avadhani, Radhik ...
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visa fler...
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Awad, Issam
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Zuccarello, Mari ...
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Ziai, Wendy C.
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Hanley, Daniel F ...
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Thompson, Richar ...
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Lindgren, Arne
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