Haemorrhagic transformation of acute cerebral ischaemia on CT
In a continuous series of 132 patients with ischaemic stroke studied in the acute phase, we assessed the occurrence and CT appearances of haemorrhagic transformation (HI) related to clinical outcome. Fiftyseven patients (43%) developed HI (only 3 had parenchymal haemorrhage). On the first CT, early signs of an ischaemic lesion were more frequent in HI (93%) than in non-HI (20%) (P<0.0001). Patients with early CT lowdensity showed a worse outcome in 74% of cases (17 dead and 33 poor outcome) compared with patients with a negative CT scan on admission, of whom 59% had a good outcome (P < 0.0002). Clinical outcome in the HI patients group was impaired to the same extent, showing a worse outcome in 78% of cases (14 dead and 30 poor outcome) compared with the non-HI group of which 57% had a good outcome (P< 0.0002). We showed a high frequency of HI in patients with stroke and documented that the haemorrhagic transformation of ischaemic stroke did not directly influence the clinical outcome, while early CT ischaemic signs may be the main predictors of both HI and clinical outcome.
key wordsCerebral ischaemia Haemorrhagic transformation Computed tomography
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