[Magnetic resonance imaging of hemorrhagic transformation in ischemic posterior infarction].
OBJECTIVE
To describe the incidence, time course, and clinical correlates of hemorrhagic transformation (HT) of ischemic stroke in the posterior cerebral artery territory.


METHODS
Within 42 months 48 patients with 52 occipital lobe infarctions were examined by T1- and T2-weighted MR imaging. The extent and distribution of secondary hemorrhage were analysed at different intervals after stroke. Volume of ischemic and hemorrhagic infarction was measured planimetrically.


RESULTS
HT was observed in 71% of the infarcts between the 5th day and up to 1 year after stroke. HT was most frequently (88%) observed in the 2nd and 3rd month. HT was present in 55% of small infarcts (< 10 cm3), in 88% of medium size (10-50 cm3), and in all large (> 50 cm3) infarcts. In 92% HT presented with petechial bleedings within the cortex (64%) or less frequently (28%) in subcortical structures. The latter types of HT showed no progression and did not increase the clinical deficits. Space-occupying bleedings occurred in only two large defects.


CONCLUSIONS
In ischemic posterior infarction, HT can frequently be detected within the first three months after stroke and is predominantly of the petechial type and seems not to be relevant with regard to clinical deficits.
Reimann
M
M
Abteilung für Neuroradiologie, Medizinische Fakultät der Humboldt-Universität zu Berlin.
Niehaus
L
L
Lehmann
R
R
D001921:Brain / Q000473:pathology; D002545:Brain Ischemia / Q000150:complications* / Q000175:diagnosis; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020762:Infarction, Posterior Cerebral Artery / Q000150:complications* / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D013997:Time Factors