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open access

Vol 3, No 2 (2001)
Prace poglądowe
Published online: 2002-11-25
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Hemorrhagic transformation of brain infarct

Konstanty Gurański, Ryszard Podemski, Maria Ejma
Udar Mózgu. Problemy Interdyscyplinarne 2001;3(2):77-84.

open access

Vol 3, No 2 (2001)
Prace poglądowe
Published online: 2002-11-25

Abstract

Hemorrhagic transformation (HT) occurs in 30–40% of patients with ischemic stroke and even more frequently in cardioembolic cases. Computer tomography scans show 2 types of hemorrhages: petechial hemorrhage (hemorrhagic infarction) and parenchymal hematoma (PH). These types of hemorrhage differ in morphology, pathogenetic mechanisms and prognostic value. Hemorrhagic infarction occurs usually in cases of large infarction and severe cerebral edema. Hemorrhagic infarction is usually detected several days after stroke onset when cerebral edema is reduced. Hemorrhagic infarction is probably caused by reperfusion after reopening of the cortical collaterals. Hemorrhagic infarction may be clinically silent and become one of the elements of natural infarct evolution. Parenchymal hematoma is caused by artery rupture. Large parenchymal hematoma may increase brain edema and may cause clinical deterioration. Hemorrhagic transformation is predicted by early CT ischemic changes, large infarction, brain edema with mass efect, severe neurological deficit, increasing age, thrombolytic and anticoagulant therapy.

Abstract

Hemorrhagic transformation (HT) occurs in 30–40% of patients with ischemic stroke and even more frequently in cardioembolic cases. Computer tomography scans show 2 types of hemorrhages: petechial hemorrhage (hemorrhagic infarction) and parenchymal hematoma (PH). These types of hemorrhage differ in morphology, pathogenetic mechanisms and prognostic value. Hemorrhagic infarction occurs usually in cases of large infarction and severe cerebral edema. Hemorrhagic infarction is usually detected several days after stroke onset when cerebral edema is reduced. Hemorrhagic infarction is probably caused by reperfusion after reopening of the cortical collaterals. Hemorrhagic infarction may be clinically silent and become one of the elements of natural infarct evolution. Parenchymal hematoma is caused by artery rupture. Large parenchymal hematoma may increase brain edema and may cause clinical deterioration. Hemorrhagic transformation is predicted by early CT ischemic changes, large infarction, brain edema with mass efect, severe neurological deficit, increasing age, thrombolytic and anticoagulant therapy.
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Keywords

ischemic stroke; hemorrhagic transformation; risk factors of hemorrhagic transformation; thrombolytic therapy

About this article
Title

Hemorrhagic transformation of brain infarct

Journal

Interdisciplinary Problems of Stroke

Issue

Vol 3, No 2 (2001)

Pages

77-84

Published online

2002-11-25

Bibliographic record

Udar Mózgu. Problemy Interdyscyplinarne 2001;3(2):77-84.

Keywords

ischemic stroke
hemorrhagic transformation
risk factors of hemorrhagic transformation
thrombolytic therapy

Authors

Konstanty Gurański
Ryszard Podemski
Maria Ejma

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