Introduction:
Despite clear outcome benefits, some physicians remain concerned about theoretical deleterious effects of intravenous thrombolysis. In the CANVAS study (Cognition and Neocortical Volume After Stroke) we have reported brain volume changes in patients following stroke. We sought here to compare brain atrophy rates of 3 groups of patients presenting with MCA stroke, versus a group of healthy control participants.
Hypothesis:
We hypothesized that IV thrombolysis would not affect brain atrophy rates following stroke.
Methods:
Three groups of patients with acute ischemic MCA stroke were included, 2 of whom received thrombolysis: 10 patients were imaged at 2 hours and at 3 months (Copenhagen cohort) and 9 patients imaged within 30 days of symptom onset and at 3 months (Melbourne CANVAS cohort). We compared regional and global brain volume and atrophy rates with 10 patients who did not receive thrombolysis and a group of 10 healthy control participants were also imaged at these timepoints. 3D MPRAGE images were acquired on a Siemens Trio 3T MRI scanner. Images were processed using Freesurfer V 5.1 with default settings. We compared baseline and 3 month average regional cortical thickness. Ipsilesional and contralesional results were analyzed separately. Paired sample t-tests were used to assess significant change.
Results:
There was no significant difference in brain volume between the 2 timepoints in our control participants. Ipsilesional white matter (WM) and gray matter (GM) volume declined over the 3 month period in all 3 stroke groups. There was no significant difference in brain atrophy rates between stroke patients who received IV thrombolysis and those who didn’t.
Conclusions:
In this pilot study, we found that thrombolysis did not affect brain atrophy rates in the stroke patients studied.
