The relationship of the type of intracerebral haemorrhage to early disease evolution and long-term prognosis after r-tPA thrombolysis

Abstract Background: To investigate the relationship of different subtypes of intracerebral haemorrhage (ICH) to early disease evolution and long-term prognosis in patients with acute cerebral infarction after intravenous recombinant tissue plasminogen activator(r-tPA). Methods: Seventy ischaemic stroke patients treated with intravenous t-PA who underwent computed tomography (CT) within 24 hours after thrombolysis were divided into four types (haemorrhagic infarction type 1 [HI-1], HI-2, parenchymal haemorrhage type 1 [PH-1], or PH-2). Early evolution of the disease was observed by the change in the National Institutes of Health Stroke Scale (NIHSS) score within 24 hours after thrombolysis. The long-term prognosis was assessed by the modified Rankin Scale (mRS) score at the 3rd month. Results: There were 17 (24.3%) patients with ICH. Compared with patients in the non-ICH group, HI did not affect early neurological function or clinical outcome at the 3rd month. PH-1 did not increase the risk of early neurological deterioration; however, PH-1 could increase the risk of death at the 3rd month (50% vs 11.3%, P = 0.090). PH-2 was significantly related to early neurological deterioration (66.7% vs 3.8%, P <0.001) and mortality at the 3rd month (50.0% vs 11.3%, P = 0.040). Conclusion: Patients with different subtypes of ICH after thrombolysis have different clinical outcomes. PH-2 is significantly associated with early neurological deterioration and increases mortality at the 3rd month.