Evaluation of the Prevalence of Intracerebral Hemorrhage and Related Factors in Patients with Acute Ischemic Stroke Receiving Tissue Plasminogen Activator

Abstract

Background: Stroke is one of the most common causes of disability. Based on reports, recombinant tissue plasminogen activator (rtPA) remains the only drug approved for the treatment of ischemic stroke and reduction of associated disabilities. One of the most common complications of this treatment is intracerebral hemorrhage (ICH), which can lead to mortality and aggravate initial symptoms. Objectives: The present study aimed to evaluate the prevalence of hemogenic factors and the most important complication inhibiting the receiving of treatment (i.e., ICH). Methods: In total, 300 patients treated with rtPA, ICH was measured by using a CT scan, and the hemorrhage level was determined. Moreover, data analysis was performed in SPSS to compare the two groups in terms of demographic, clinical, and paraclinical findings, including age, gender, blood glucose level, the NIHSS score, early CT scores, history of diabetes, myocardial infarction and stroke, hypertension, aspirin use, and smoking status. Results: Intracerebral hemorrhage was detected in 35 out of 300 patients. The mean age of the ICH group was 74 ± 14 years and significantly higher than the non-ICH group (68 ± 14 years) (P = 0.007). The mean NIHSS score was estimated at 15 ± 5 and 12 ± 5 in the ICH and non-ICH groups, respectively (P = 0.001). More bleeding was observed in patients with the upper one-third lesion of the infarct in the MCA arterial territory (P = 0.027). Conclusions: The prevalence of cerebral hemorrhage was 11.7% with 7.6% symptomatic ICH.