Thrombolysis for acute ischemic stroke in patients with leukoaraiosis: Caution needed

The term leukoaraiosis (LA), introduced about 30 years ago,1 describes cerebral white matter signal abnormalities (or white matter hyperintensities) commonly observed on structural brain magnetic resonance or CT imaging in elderly individuals. LA severity can be graded using categorical classification, based on different rating scales,2 or continuously, using automatic quantification algorithms. LA has multiple histopathologic correlates, including ependymal loss, cerebral ischemia, demyelination, venous collagenosis, and microcystic infarcts.3 A substantial body of evidence now supports associations between LA and increased risk for motor disability, dementia, and mortality,4 as well as an increased risk for future stroke or TIA.5 LA strongly associates with increasing age and vascular risk factors.6 Particularly, recent studies found associations between LA extent and increased risk for symptomatic intracerebral hemorrhage (sICH) with thrombolytic agents,7 as well as with the use of antithrombotic agents and anticoagulants.8 Yet in spite of overwhelming evidence of such associations, LA is not considered as a relevant indicator in the assessment checklists for consideration of the use of thrombolytic agents after an acute ischemic stroke (AIS).9
Source: Neurology - Category: Neurology Authors: Tags: All Cerebrovascular disease/Stroke, Clinical trials Systematic review/meta analysis, Infarction, Intracerebral hemorrhage EDITORIALS Source Type: research

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Source: Research in Developmental Disabilities - Category: Disability Source Type: research
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Source: Research in Developmental Disabilities - Category: Disability Source Type: research
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Source: International Neurourology Journal - Category: Urology & Nephrology Tags: Int Neurourol J Source Type: research
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Source: Tijdschrift voor Psychiatrie - Category: Psychiatry Authors: Tags: Tijdschr Psychiatr Source Type: research
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Source: Journal of Rehabilitation Medicine - Category: Rehabilitation Tags: J Rehabil Med Source Type: research
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Source: Journal of Rehabilitation Medicine - Category: Rehabilitation Tags: J Rehabil Med Source Type: research
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Source: Journal of Rehabilitation Medicine - Category: Rehabilitation Tags: J Rehabil Med Source Type: research
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