A Clinical Study of Hemorrhagic Infarction.
- Author:
Young Cheol CHOI
1
;
Chin Sang CHUNG
;
Seon Woo NAM
;
Ae Young LEE
;
Jae Moon KIM
Author Information
1. Department of Neurology, Chugnam National University Medical College and Hospital, Taejon, Korea.
- Publication Type:Original Article
- MeSH:
Brain;
Carotid Arteries;
Cerebral Infarction;
Embolism;
Humans;
Infarction*;
Magnetic Resonance Imaging;
Migraine Disorders;
Moyamoya Disease;
Neuroimaging;
Purpura, Thrombotic Thrombocytopenic;
Reperfusion;
Retrospective Studies;
Sinus Thrombosis, Intracranial;
Stroke
- From:Journal of the Korean Neurological Association
1995;13(3):479-489
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Hemorrhagic conversion (HC) of a cerebral infarct is a radiological sign of reperfusion to the infarcted tissue. Recently the concept on HC needs to be revised in relation to advanced therapeutic trials for acute ischeniic strokes. To investigate the clinical significance of HC of a bland cerebral infarct, we analyzed the clinical and neuroimaging files of 70 stroke patients showing HC on the brain CT and/or MRI scans. We also studied the best-possible stroke mechanisms on clinicolaboratory grounds, the factors that might have contributed to HC, and the prognostic impact of HC. Of 70 patients with HC, 51 had infarcts in the carotid artery system, 18 in the vertebrobasilar system, and 1 in cerebral venous system. Definite cardioembolic sources were identified in 21 patients (30%). HC was associated with antithrombotic therapy in 21 patients (30%). Other stroke mechanisms included migraine (23 cases), moyamoya disease (2, cases), thrombotic thrombocytopenic purpura (I case), postoperative vasospasm (1 case), and dural sinus thrombosis (I case). We identified a subset of 14 patients with HC of isolated subcortical infarcts but without definite embolic sources. Sixty-four of 70 patients (91.5%) remained clinically stable or improved after HC, suggesting a relative safety of HC in this retrospective study. In conclusion HC follows cerebral infarctions caused by various non-embolic mechanisms as well as by embolism. HC was not a bad prognostic sign in tl-iis small series.
