Hemorrhagic transformation of ischemic stroke

Abstract

The article reviews the problem of hemorrhagic transformation (HT) of ischemic stroke. The frequency and relevance of this complication in clinical practice is high considering the widespread implementation of cerebral recanalization methods: intravenous thrombolytic therapy and intravascular thromboembolectomy. The etiology and pathogenesis, as well as alternative mechanisms underlying the development of HT are also discussed. The probability of HT increases in case of extensive cerebral ischemia commonly associated with cardiac embolism. The role of spontaneous and medication-induced arterial recanalization of cerebral arteries in the genesis HT is discussed. In particular, it is noted that arterial recanalization is not an essential factor for the occurrence of HT in cerebral infarction. The severity of HT is determined by the duration and degree of cerebral ischemia. There is a need for a targeted search for HT predictors. The classification of types and criteria of HT are presented. The risk factors and scales used to predict HT are studied. Risk factors for HT are combined into several groups: clinical, laboratory, genetic, neuroimaging. Their comparative analysis is carried out and practical significance is estimated.