Patterns and Predictors of Extra-Corporeal Membrane Oxygenation Related Cerebral Microbleeds
| Autor: | Kamran Masood, Eva Mistry, Tapan Mehta, Bentho Oladi, Jason A. Bartos, Andrew Zhang, Hüseyin Gürkan Töre, Haitham M. Hussein, Bhavani Kashyap, Karan Topiwala, Mustapha Ezzeddine, Bharathi D. Jagadeesan |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Splenium Extracorporeal Membrane Oxygenation Risk Factors Internal medicine medicine Middle cerebellar peduncle Extracorporeal membrane oxygenation Humans Stroke Cerebral Hemorrhage Retrospective Studies business.industry Rehabilitation Leukoaraiosis Retrospective cohort study Oxygenation Middle Aged medicine.disease medicine.anatomical_structure Cardiology Surgery Neurology (clinical) Cardiology and Cardiovascular Medicine business Lipohyalinosis |
| Zdroj: | Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 31(1) |
| ISSN: | 1532-8511 |
| Popis: | Objectives Recent case-reports have described an atypical cerebral microbleed (CMB) topography after extracorporeal membrane oxygenation (ECMO). The objective of this study was to examine the prevalence, radiographic patterns, and clinical correlates of possibly-ECMO-related (PER) CMB. Materials and methods We performed a retrospective study of 307 consecutive patients receiving ECMO support at our tertiary-care University Hospital (2013–2018). PER CMB were defined as CMB present in corpus-callosum and/or middle cerebellar peduncle with/without involvement of other lobar/deep structures. Leukoaraiosis was quantified using the Wahlund age-related white matter changes scale. Patient characteristics were compared between cohorts with and without PER CMB. Results Forty patients (median age 60 years; 33% vv-ECMO and 67% va-ECMO) received at-least one MRI-brain within 3 months of ECMO support. CMB were present in 77.5% (n = 31) patients with 39% (n = 12), 17% (n = 5), and 44% (n = 14) having low ( 30 CMB) burden respectively. Among CMB-positive patients, 71% (n = 22) had PER CMB, with 91% of such cases demonstrating involvement of splenium. Leukoaraiosis did not corelate to PER CMB presence (p = 0.267) or burden (ρ = 0.09). Patients with PER CMB had higher rates of ischemic stroke (50 vs. 33%), intracranial hemorrhage (41 vs. 17%), and all-cause mortality (27 vs. 17%); with survivors demonstrating no differences in their discharge disposition or modified Rankin Score. Conclusions Post-ECMO cerebral microbleeds have a distinct distribution pattern that commonly involves the splenium of corpus-callosum. Their etiopathogenesis may be independent of microvascular lipohyalinosis. This requires further study in a larger sample-size. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect