Browsing by Author "Ruuskanen, Reetta"

Background and purpose: To find out factors associated with development of symptomatic intracranial haemorrhage (sICH) in patients with basilar artery occlusion. Patients were treated with intravenous alteplase and full-dose anticoagulation with heparin. Methods: The data is from a consecutive cohort of 176 BAO patients treated at Helsinki University Central Hospital during the period between 1995-2013. sICH was judged according to European Cooperative Acute Stroke Study II. The extent of baseline ischemia was evaluated with posterior circulation Acute Stroke Prognosis Early CT score (pc-ASPECTS). Modified Rankin Scale (mRS) at three months was used to rate the outcome. Favourable outcome was rated as 0 to 2 and unfavourable as 3 to 6. Results: 13.6% of patients developed sICH. Pc-ASPECTS under 8 independently increased the risk of sICH (p = 0.031). 70.3% of patients had 3-month mRS 3 to 6, among whom were all sICH cases. High mean systolic blood pressure two hours after thrombolysis was independently associated with development of sICH (p = 0.034). Platelet count at baseline and 24 hours after tPA and heparin administration was lower in patients with sICH than without sICH. Activated partial thromboplastin time (APTT) values didn't associate with developing sICH. Interpretation: Low to normal platelet count, extensive baseline ischemic changes and high systolic blood pressure at 2 hours after treatment increased the risk of developing sICH.