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Hemorrhagic cerebral infarction--a prospective study.

C R Hornig, W Dorndorf, A L Agnoli

    Stroke
    |March 1, 1986
    PubMed
    Summary
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    Hemorrhagic transformation is common after ischemic stroke, particularly in patients with severe deficits. Early contrast enhancement on CT scans indicates a higher risk of bleeding, potentially worsening neurological outcomes.

    Area of Science:

    • Neurology
    • Radiology
    • Cardiology

    Background:

    • Ischemic cerebral infarction is a significant cause of neurological disability.
    • Hemorrhagic transformation (HT) is a known complication of ischemic stroke.
    • Understanding risk factors for HT is crucial for patient management.

    Purpose of the Study:

    • To investigate the incidence and timing of hemorrhagic transformation in ischemic cerebral infarction.
    • To identify clinical and radiological predictors of hemorrhagic transformation.
    • To correlate the etiology of infarction with the occurrence of hemorrhagic transformation.

    Main Methods:

    • Prospective study of 65 patients with ischemic cerebral infarction.
    • Serial CT scans and neurological assessments over 4 weeks post-stroke.

    Related Experiment Videos

  • Evaluation of etiological factors using angiography, ultrasound, and cardiology.
  • Lumbar puncture in 43 patients to determine serum/CSF albumin ratio.

    • Main Results:

    • Hemorrhagic transformation occurred in 28 patients (43%), with 11 in the first week and 15 in the second week.
    • Risk factors for HT included severe neurological deficit, impaired consciousness, large infarcts with mass effect, early contrast enhancement on CT, cortical involvement, and blood/CSF barrier disturbances.
    • Cardiac embolism was a frequent etiology in patients with early HT.
    • Early HT was associated with frank hematoma, while late HT showed cortical hemorrhagic changes.

    Conclusions:

    • Hemorrhagic transformation is a frequent complication of ischemic stroke with identifiable risk factors.
    • Early detection of risk factors, especially via CT imaging, is vital for predicting and potentially managing HT.
    • The etiology, particularly cardiac embolism, influences the pattern and timing of hemorrhagic transformation.