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Hemorrhagic transformation in cerebral embolism
Y Okada1, T Yamaguchi, K Minematsu
1Department of Internal Medicine, National Cardiovascular Center, Suita City, Japan.
Stroke
|May 1, 1989
Summary
Hemorrhagic infarction after cerebral embolism is common, particularly in older patients and those with larger infarcts. Vessel reopening contributes, but age and infarct size are key factors, not hypertension.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Cerebral embolism can lead to hemorrhagic infarction.
- Understanding the factors influencing hemorrhagic transformation is crucial for patient management.
Purpose of the Study:
- To investigate the mechanism and incidence of hemorrhagic infarction following acute cerebral embolism.
- To identify patient and imaging factors associated with hemorrhagic infarction.
Main Methods:
- Study included 160 patients with acute cerebral embolism.
- Brain computed tomography and angiography were used to assess infarcts and vessel status.
- Follow-up imaging was performed to evaluate vessel recanalization.
Main Results:
- Hemorrhagic infarction occurred in 40.6% of patients within one month.
- Higher incidence observed in patients aged ≥70 years (50.8%) and those with moderate/large infarcts (50.0-51.5%).
- Vessel reopening was noted in 94.9% of patients with follow-up angiography; no correlation with hypertension or acute blood pressure.
Conclusions:
- Hemorrhagic transformation in cerebral embolism is multifactorial, influenced by age and infarct size, in addition to vessel reopening.
- Hypertension appears less critical for hemorrhagic infarction development.
- Thrombolytic/anticoagulant therapy did not alter incidence but may increase massive hematoma risk.