A risk score to predict intracranial hemorrhage after recombinant tissue plasminogen activator for acute ischemic stroke

J Stroke Cerebrovasc Dis. 2008 Nov-Dec;17(6):331-3. doi: 10.1016/j.jstrokecerebrovasdis.2008.03.012.


Background: Ability to predict risk of postthrombolysis intracerebral hemorrhage (ICH) is currently limited.

Methods: Using data from the Multicenter Recombinant Tissue Plasminogen Activator Stroke Survey Group, we developed a score to predict this risk. One point was assigned for the presence of each of 4 variables: age older than 60 years, baseline National Institutes of Health Stroke Scale score greater than 10, glucose greater than 8.325 mmol/L, and platelet count less than 150,000/mm(3).

Results: Rate of any ICH increased with higher scores: 0 points, 2.6%; 1 point, 9.7%; 2 points, 15.1%; and greater than or equal to 3 points, 37.9%. The model had reasonable discriminatory capability (C-statistic 0.69). A similar pattern was seen with symptomatic and asymptomatic ICH separately, and with radiographically defined parenchymal hemorrhage.

Conclusion: A simple risk score may be useful for predicting postthrombolysis ICH.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Blood Coagulation Disorders
  • Brain Ischemia / drug therapy*
  • Cerebral Angiography
  • Cerebral Arteries / diagnostic imaging
  • Cerebral Arteries / drug effects
  • Cerebral Arteries / physiopathology
  • Cerebral Hemorrhage / chemically induced*
  • Cerebral Hemorrhage / epidemiology*
  • Fibrinolytic Agents / adverse effects
  • Humans
  • Hyperglycemia / epidemiology
  • Patient Selection
  • Platelet Count
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Risk Assessment / methods
  • Risk Factors
  • Stroke / drug therapy*
  • Tissue Plasminogen Activator / adverse effects*


  • Fibrinolytic Agents
  • Tissue Plasminogen Activator