Hemorrhagic transformation
Hemorrhagic transformation (HT) or hemorrhagic conversion is a medical complication that can occur in the brain following an acute ischemic stroke, a condition in which blood flow to the brain is blocked.
| Hemorrhagic transformation | |
|---|---|
| Specialty | Neurology |
| Usual onset | In majority seen within 4 days of initial stroke. In patients treated with thrombolysis - within 24 hours. |
| Types | petechial hemorrhage, parenchymal hemorrhage |
| Diagnostic method | Brain computed tomography (CT) angiography |
Hemorrhagic transformation is a process which involves the bleeding of brain tissue that has been affected by the stroke and can take two forms: petechial hemorrhage and parenchymal hemorrhage.
HT can lead to further damage to the brain tissue and worsen the outcome of the initial stroke. The risk of HT increases with the severity and duration of the initial stroke, as well as with certain medical conditions such as high blood pressure, diabetes, and clotting disorders and the use of certain medications, such as anticoagulants and thrombolytic tpA medication (such as alteplase) which can increase the bleeding risk.
Effective treatment is complex and may involve medications to control bleeding (reversing coagulopathy), management of underlying medical conditions, and sometimes neurosurgical treatment to reduce the bleeding.