Evidence map›Paper›PMID 27316247›Full record

Trial reportNeurology2016

Pretreatment blood-brain barrier disruption and post-endovascular intracranial hemorrhage.

Richard Leigh, Søren Christensen, Bruce C V Campbell, Michael P Marks, Gregory W Albers, Maarten G Lansberg, DEFUSE 2 Investigators

Open access · greenAbstract readClinical TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
53citing papers in PubMed, 1 pooled it
4.5field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

53 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.

  1. Pooled it
  2. Systemic immune-inflammation index predicts hemorrhagic transformation after endovascular therapy for ischemic stroke.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
  3. Article
  4. Review
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  6. Article
  7. Article
  8. Review
  9. Review
  10. Article
  11. Review
  12. Review
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  15. Biomarkers of blood-brain barrier and neurovascular unit integrity in human cognitive impairment and dementia.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Review
  16. Article
  17. Article
  18. Blood-brain barrier breakdown in brain ischemia: Insights from MRI perfusion imaging.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
    Review
  19. Observational
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 2 countries.

Richard LeighFrom the Neuro Vascular Brain Imaging Unit (R.L.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Stanford Stroke Center (S.C., G.W.A., M.G.L.), Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA; Department of Medicine and Neurology (B.C.V.C.), Royal Melbourne Hospital, University of Melbourne, Australia; and Department of Radiology (M.P.M.), Stanford University Medical Center, CA. richard.leigh@nih.gov.
Søren ChristensenFrom the Neuro Vascular Brain Imaging Unit (R.L.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Stanford Stroke Center (S.C., G.W.A., M.G.L.), Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA; Department of Medicine and Neurology (B.C.V.C.), Royal Melbourne Hospital, University of Melbourne, Australia; and Department of Radiology (M.P.M.), Stanford University Medical Center, CA.
Bruce C V CampbellFrom the Neuro Vascular Brain Imaging Unit (R.L.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Stanford Stroke Center (S.C., G.W.A., M.G.L.), Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA; Department of Medicine and Neurology (B.C.V.C.), Royal Melbourne Hospital, University of Melbourne, Australia; and Department of Radiology (M.P.M.), Stanford University Medical Center, CA.
Michael P MarksFrom the Neuro Vascular Brain Imaging Unit (R.L.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Stanford Stroke Center (S.C., G.W.A., M.G.L.), Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA; Department of Medicine and Neurology (B.C.V.C.), Royal Melbourne Hospital, University of Melbourne, Australia; and Department of Radiology (M.P.M.), Stanford University Medical Center, CA.
Gregory W AlbersFrom the Neuro Vascular Brain Imaging Unit (R.L.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Stanford Stroke Center (S.C., G.W.A., M.G.L.), Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA; Department of Medicine and Neurology (B.C.V.C.), Royal Melbourne Hospital, University of Melbourne, Australia; and Department of Radiology (M.P.M.), Stanford University Medical Center, CA.
Maarten G LansbergFrom the Neuro Vascular Brain Imaging Unit (R.L.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD; Stanford Stroke Center (S.C., G.W.A., M.G.L.), Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA; Department of Medicine and Neurology (B.C.V.C.), Royal Melbourne Hospital, University of Melbourne, Australia; and Department of Radiology (M.P.M.), Stanford University Medical Center, CA.
DEFUSE 2 Investigators
National Institutes of Health · USNational Institute of Neurological Disorders and Stroke · US

Funding

Using MRI to Understand Disease States that Occur at the Interface of the Brain and the Cerebral CirculationZIANS003151 · NINDS · NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE · PI LEIGH, RICHARD · 2015 to 2023
$6.8M
Who Benefits from tPA 3-6 hours after StrokeK23NS051372 · NINDS · STANFORD UNIVERSITY · PI LANSBERG, MAARTEN G · 2006 to 2010
$912k
Intramural NIH HHS ZIA NS003151NINDS NIH HHS K23 NS051372
6 · The paper itself

Abstract

objectiveThis study sought to confirm the relationship between the degree of blood-brain barrier (BBB) damage and the severity of intracranial hemorrhage (ICH) in a population of patients who received endovascular therapy.

methodsThe degree of BBB disruption on pretreatment MRI scans was analyzed, blinded to follow-up data, in the DEFUSE 2 cohort in which patients had endovascular therapy within 12 hours of stroke onset. BBB disruption was compared with ICH grade previously established by the DEFUSE 2 core lab. A prespecified threshold for predicting parenchymal hematoma (PH) was tested.

resultsOf the 108 patients in the DEFUSE 2 trial, 100 had adequate imaging and outcome data and were included in this study; 24 developed PH. Increasing amounts of BBB disruption on pretreatment MRIs was associated with increasing severity of ICH grade (p = 0.004). BBB disruption on the pretreatment scan was associated with PH (p = 0.020) with an odds ratio for developing PH of 1.69 for each 10% increase in BBB disruption (95% confidence interval 1.09-2.64), although a reliably predictive threshold was not identified.

conclusionsThe amount of BBB disruption on pretreatment MRI is associated with the severity of ICH after acute intervention. This relationship has now been identified in patients receiving IV, endovascular, and combined therapies. Further study is needed to determine its role in guiding treatment.

Indexed as

AgedBlood-Brain BarrierEndovascular ProceduresFemaleGadoliniumHematomaHumansIntracranial HemorrhagesMagnetic Resonance ImagingMaleNeuroimagingPatient SelectionSeverity of Illness IndexSingle-Blind MethodStrokeGadolinium

Identifiers

PMID27316247
PMCPMC4955280
OpenAlexW2442033361

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.