Trial reportStroke2021
Diffusion-Weighted Imaging Lesions After Intracerebral Hemorrhage and Risk of Stroke: A MISTIE III and ATACH-2 Analysis.
Trial report in Stroke, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
What it found
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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.
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.
Who cites it
19 citing papers in PubMed, 24 citations in OpenAlex.
- Association Between Hematoma Volume and Risk of Subsequent Ischemic Stroke: A MISTIE III and ATACH-2 Analysis.Stroke · 2024Trial
- Dysregulated neuroendocrine stress response and blood pressure management burden are linked to remote diffusion-weighted imaging lesions after intracerebral hemorrhage: a prospective pilot study.Hypertension research : official journal of the Japanese Society of Hypertension · 2026Article
- DWI-Positive Lesions in Patients With Acute Intracerebral Hemorrhage: Associations With Cerebral Small Vessel Disease and Clinical Outcome.Neurology · 2026Article
- DWI-Positive Lesions in Acute Intracerebral Hemorrhage and Their Correlation With Small Vessel Disease: A Cohort Study.Neurology · 2025Article
- A rare case of unexplained recurrent intracerebral haemorrhage.Journal of surgical case reports · 2025Article
- Benefits of early MR-Imaging in patients with acute spontaneous intracerebral hemorrhage: a retrospective study.BMC neurology · 2024Article
- Intracerebral haemorrhage - mechanisms, diagnosis and prospects for treatment and prevention.Nature reviews. Neurology · 2024Review
- Prevalence of small vessel disease and incidental DWI-positive lesions in patients with aneurysmal subarachnoid hemorrhage versus intracerebral hemorrhage.European stroke journal · 2024Article
- Suboptimal Cerebral Perfusion is Associated with Ischemia After Intracerebral Hemorrhage.Neurocritical care · 2024Article
- Neuro-imaging in intracerebral hemorrhage: updates and knowledge gaps.Frontiers in neuroscience · 2024Review
- Interaction between cerebral small vessel disease, blood pressure, and remote ischemic lesions in acute spontaneous intracerebral hemorrhage.European stroke journal · 2023Article
- Changes in Cerebral Blood Flow and Diffusion-Weighted Imaging Lesions After Intracerebral Hemorrhage.Translational stroke research · 2022Review
- Review
- Cerebral Microbleeds and Acute Hematoma Characteristics in the ATACH-2 and MISTIE III Trials.Neurology · 2022Article
- Diffusion-weighted imaging hyperintensities during the chronic stage of intracerebral hemorrhage with surgery: A new clinical situation or post-surgery artifact?Frontiers in neurology · 2022Article
- Ischemia in intracerebral hemorrhage: A comparative study of small-vessel and large-vessel diseases.Annals of clinical and translational neurology · 2022Observational
- Cerebral Autoregulation and Neurovascular Coupling in Acute and Chronic Stroke.Frontiers in neurology · 2021Article
- Remote diffusion-weighted imaging lesions in spontaneous intracerebral hemorrhage: research progress and new perspectives.Frontiers in neurologyReview
- Associations of intracranial arterial stenosis and cerebral small vessel diseases with acute ischemic lesions in spontaneous intracerebral hemorrhage.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
15 authors at 5 institutions in 1 country.
Funding
Abstract
background and purposePunctate ischemic lesions noted on diffusion-weighted imaging (DWI) are associated with poor functional outcomes after intracerebral hemorrhage (ICH). Whether these lesions increase long-term risk of stroke is poorly understood.
methodsWe pooled individual patient data from the ATACH-2 trial (Antihypertensive Treatment of Acute Cerebral Hemorrhage) and the MISTIE III trial (Minimally Invasive Surgery Plus Alteplase for Intracerebral Hemorrhage Evacuation Phase 3). We included subjects with a magnetic resonance imaging scan. The exposure was a DWI lesion. The primary outcome was any stroke, defined as a composite of ischemic stroke or recurrent ICH, whereas secondary outcomes were incident ischemic stroke and recurrent ICH. Using multivariate Cox regression analysis, we evaluated the risk of stroke.
resultsOf 505 patients with ICH with magnetic resonance imaging, 466 were included. DWI lesions were noted in 214 (45.9%) subjects, and 34 incident strokes (20 ischemic stroke and 14 recurrent ICH) were observed during a median follow-up of 324 days (interquartile range, 91-374). Presence of a DWI lesion was associated with a 6.9% (95% CI, 2.2-11.6) absolute increase in risk of all stroke (hazard ratio, 2.6 [95% CI, 1.2-5.7]). Covariate adjustment with Cox regression models also demonstrated this increased risk. In the secondary analyses, there was an increased risk of ischemic stroke (hazard ratio, 3.5 [95% CI, 1.1-11.0]) but not recurrent ICH (hazard ratio, 1.7 [95% CI, 0.6-5.1]).
conclusionsIn a heterogeneous cohort of patients with ICH, presence of a DWI lesion was associated with a 2.5-fold heightened risk of stroke among ICH survivors. This elevated risk persisted for ischemic stroke but not for recurrent ICH.
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Registered trials
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.