New ischaemic brain lesions in cervical artery dissection stratified to antiplatelets or anticoagulants.
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| Title: | New ischaemic brain lesions in cervical artery dissection stratified to antiplatelets or anticoagulants. |
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| Authors: | Gensicke, H., Ahlhelm, F., Jung, S., Hessling, A., Traenka, C., Goeggel Simonetti, B., Peters, N., Bonati, L. H., Fischer, U., Broeg ‐ Morvay, A., Seiffge, D. J., Gralla, J., Stippich, C., Baumgartner, R. W., Lyrer, P. A., Arnold, M., Engelter, S. T. |
| Source: | European Journal of Neurology. May2015, Vol. 22 Issue 5, p859-859. 8p. |
| Subjects: | Brain damage, Anticoagulants, Brain imaging, Fibrinolytic agents, Magnetic resonance imaging, Diffusion magnetic resonance imaging |
| Abstract: | Background and purpose To determine the frequency of new ischaemic or hemorrhagic brain lesions on early follow-up magnetic resonance imaging ( MRI) in patients with cervical artery dissection ( CAD) and to investigate the relationship with antithrombotic treatment. Methods This prospective observational study included consecutive CAD patients with ischaemic or non-ischaemic symptoms within the preceding 4 weeks. All patients had baseline brain MRI scans at the time of CAD diagnosis and follow-up MRI scans within 30 days thereafter. Ischaemic lesions were detected by diffusion-weighted imaging ( DWI), intracerebral bleeds ( ICBs) by paramagnetic-susceptible sequences. Outcome measures were any new DWI lesions or ICBs on follow-up MRI scans. Kaplan- Meier statistics and calculated odds ratios with 95% confidence intervals were used for lesion occurrence, baseline characteristics and type of antithrombotic treatment (antiplatelet versus anticoagulant). Results Sixty-eight of 74 (92%) CAD patients were eligible for analysis. Median (interquartile range) time interval between baseline and follow-up MRI scans was 5 (3-10) days. New DWI lesions occurred in 17 (25%) patients with a cumulative 30-day incidence of 41.3% (standard error 8.6%). Occurrence of new DWI lesions was associated with stroke or transient ischaemic attack at presentation [7.86 (2.01-30.93)], occlusion of the dissected vessel [4.09 (1.24-13.55)] and presence of DWI lesions on baseline MRI [6.67 (1.70-26.13)]. The type of antithrombotic treatment had no impact either on occurrence of new DWI lesions [1.00 (0.32-3.15)] or on functional 6-month outcome [1.27 (0.41-3.94)]. No new ICBs were observed. Conclusion New ischaemic brain lesions occurred in a quarter of CAD patients, independently of the type of antithrombotic treatment. MRI findings could potentially serve as surrogate outcomes in pilot treatment trials. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | Background and purpose To determine the frequency of new ischaemic or hemorrhagic brain lesions on early follow-up magnetic resonance imaging ( MRI) in patients with cervical artery dissection ( CAD) and to investigate the relationship with antithrombotic treatment. Methods This prospective observational study included consecutive CAD patients with ischaemic or non-ischaemic symptoms within the preceding 4 weeks. All patients had baseline brain MRI scans at the time of CAD diagnosis and follow-up MRI scans within 30 days thereafter. Ischaemic lesions were detected by diffusion-weighted imaging ( DWI), intracerebral bleeds ( ICBs) by paramagnetic-susceptible sequences. Outcome measures were any new DWI lesions or ICBs on follow-up MRI scans. Kaplan- Meier statistics and calculated odds ratios with 95% confidence intervals were used for lesion occurrence, baseline characteristics and type of antithrombotic treatment (antiplatelet versus anticoagulant). Results Sixty-eight of 74 (92%) CAD patients were eligible for analysis. Median (interquartile range) time interval between baseline and follow-up MRI scans was 5 (3-10) days. New DWI lesions occurred in 17 (25%) patients with a cumulative 30-day incidence of 41.3% (standard error 8.6%). Occurrence of new DWI lesions was associated with stroke or transient ischaemic attack at presentation [7.86 (2.01-30.93)], occlusion of the dissected vessel [4.09 (1.24-13.55)] and presence of DWI lesions on baseline MRI [6.67 (1.70-26.13)]. The type of antithrombotic treatment had no impact either on occurrence of new DWI lesions [1.00 (0.32-3.15)] or on functional 6-month outcome [1.27 (0.41-3.94)]. No new ICBs were observed. Conclusion New ischaemic brain lesions occurred in a quarter of CAD patients, independently of the type of antithrombotic treatment. MRI findings could potentially serve as surrogate outcomes in pilot treatment trials. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 13515101 |
| DOI: | 10.1111/ene.12682 |
