Hemorrhagic transformation of brain infarct

Abstract

HT of a brain infarct is a common event that occurs independently of anticoagulation and can be reliably predicted as early as 5 hours from stroke onset by the presence of focal hypodensity at CT. Apart from the infrequent cases of massive hematoma, HT does not influence prognosis, whereas a poor outcome in HT patients is correlated with a higher frequency of large edematous infarcts in this subgroup. The clinical course and final outcome of HT in anticoagulated patients does not differ from that of non-anticoagulated HT patients.

Haemorrhagic transformation in ischaemic stroke is more frequent than clinically suspected – A neuropathological study

“…Toni et al examined 150 consecutive patients with cerebral infarct in the anterior circulation. They performed CT or autopsy one week after the stroke and observed haemorrhagic transformations in 43%, mostly (89%) petechial haemorrhagic transformations and in 11% larger haematomas [6]. Celik et al evaluated a series of 86 middle cerebral artery territorial infarction cases, who had received before neither antiplatelet nor anticoagulant therapy.…”

“…Haemorrhagic infarction is a frequent complication of ischaemic stroke [6][7][8], although it is not always accompanied by clinical deterioration [7][8][9][10]. The effect on clinical outcome is also unclear and most of the literature data regained from studies on thrombolysis for…”

Association of CT Perfusion Parameters with Hemorrhagic Transformation in Acute Ischemic Stroke

“…12 Ongoing effort to find predictors of HT has yielded various factors, including the etiology of stroke, extent of infarction on initial CT, increasing stroke severity (NIHSS score), increasing age, congestive heart failure, high glucose levels, and blood pressure on presentation. 11,[13][14][15][16][17] Serum markers such as matrix metalloproteinase-9 levels 18 ; imaging modalities such as CT, 19 SPECT, 20 MR imaging, 21 diffusion-and perfusion-weighted MR imaging 22 ; and blood-brain barrier permeability measures on CTP 23 are also under investigation to formulate predictive models for HT.…”

Bilateral intracerebral hemorrhage following CPR

“…Furthermore, it has been widely stated in the literature that the peak occurrence of hemorrhagic cerebral infarction is in the first week after stroke. (11,12) Therefore, in this patient, the most appropriate mechanism may be the hemorrhagic transformation of brain infarction, which was due to global ischemia following prolonged CPR. Another possibility is that delayed hyperemia occurred during the post-cardiac arrest period.…”