{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T12:30:29Z","timestamp":1787056229048,"version":"build-2736575974"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Objectives:<\/jats:title>\n                    <jats:p>Symptomatic intracranial hemorrhage (SICH) after thrombolysis is a major safety concern in the management of acute ischemic stroke (AIS). This study evaluates the predictors and outcomes of SICH among AIS patients receiving tenecteplase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This multicenter retrospective observational study included AIS patients who received tenecteplase between December 2021 and June 2024 at 41 Swasthya Ingit Telestroke Network hospitals in West Bengal, India.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of 1,463 tenecteplase-treated AIS patients, 68 (4.64%) developed SICH. Mixed-effects multivariable logistic regression showed that age &gt;61 years (adjusted odds ratio [aOR] 2.37, 95% confidence interval [CI] 1.38\u20134.07), hyperlipidemia (aOR 2.84, 95% CI 1.28\u20136.31), atrial fibrillation (aOR 4.84, 95% CI 1.86\u201312.59), smoking (aOR 2.55, 95% CI 1.30\u20135.00), systolic blood pressure &gt;150 mmHg on admission (aOR 2.09, 95% CI 1.25\u20133.48), and a baseline National Institutes of Health Stroke Scale (NIHSS) score &gt;9 (aOR 1.71, 95% CI 1.03\u20132.86) were associated with higher odds of SICH. An Alberta Stroke Program Early CT Score (ASPECTS) &lt;8 was an additional risk factor among patients with middle cerebral artery (MCA) territory infarcts (aOR 3.32, 95% CI 1.70\u20136.50). Among the 313 patients who underwent angiography, the presence of large vessel occlusion was also associated with increased odds of SICH (aOR 5.65, 95% CI 1.86\u201317.19). In the SICH group, significantly fewer patients achieved a favorable outcome (mRS 0\u20132) at 90 days (7.4% vs 60.6%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and all-cause mortality was significantly higher (79.4% vs 12.3%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>SICH after tenecteplase use in AIS is associated with increased morbidity and mortality. Older age, higher baseline NIHSS scores, elevated systolic blood pressure on admission, smoking, hyperlipidemia, atrial fibrillation, lower ASPECTS, and large vessel occlusion are associated with a higher risk of SICH in tenecteplase-treated AIS patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aian.aian_6_26","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T10:00:48Z","timestamp":1784628048000},"page":"585-590","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Incidence, Predictors, and Outcomes of Symptomatic Intracranial Hemorrhage after Tenecteplase in Acute Ischemic Stroke"],"prefix":"10.4103","volume":"29","author":[{"given":"Arpan","family":"Dutta","sequence":"first","affiliation":[{"name":"Department of Neurology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uddalak","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhadeep","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soumozit","family":"Banerjee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chayan","family":"Mondal","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnab","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Department of Health and Family Welfare, Govt. of West Bengal, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deep","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Neurology, G S Neuroscience Clinic and Research Center, Patna, Bihar, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shashvat M","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Neurology, HonorHealth, Scottsdale, AZ, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashutosh P","family":"Jadhav","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Snehasis","family":"Das","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Jhargram Govt. Medical College and Hospital, Jhargram, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samir K","family":"Datta","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Suri District Hospital, Suri, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chinmoy","family":"Barik","sequence":"additional","affiliation":[{"name":"Department of General Medicine, College of Medicine and Jawaharlal Nehru Memorial Hospital, Kalyani, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Somnath","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Vidyasagar State General Hospital, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bichitra","family":"Biswas","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Basirhat District Hospital, Basirhat, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suprim","family":"Sadhukhan","sequence":"additional","affiliation":[{"name":"Department of Critical Care, Imambara District Hospital, Hooghly, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Souvik","family":"Sen","sequence":"additional","affiliation":[{"name":"Department of Health and Family Welfare, Govt. of West Bengal, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soumya","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Health and Family Welfare, Govt. of West Bengal, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitai C","family":"Mandal","sequence":"additional","affiliation":[{"name":"Department of Health and Family Welfare, Govt. of West Bengal, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subhransu S","family":"Datta","sequence":"additional","affiliation":[{"name":"Department of Health and Family Welfare, Govt. of West Bengal, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Swapan","family":"Saren","sequence":"additional","affiliation":[{"name":"Department of Health and Family Welfare, Govt. of West Bengal, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manimoy","family":"Bandyopadhyay","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Biman K","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Neurology, Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, 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