title: Hemorrhagic transformation of stroke secondary to spontaneous internal carotid artery dissection.
abstract: The clinical course of patients with hemorrhagic transformation in stroke secondary to spontaneous cervical internal carotid artery dissection (ICAD) has not been elucidated. We report a 36-year-old man with presentation of headache and subsequent left hemiparesis. Magnetic resonance imaging disclosed right ICAD with nearly complete occlusion of the right distal internal carotid artery and infarction over the right basal ganglion with hemorrhagic transformation in its central area. Hemorrhagic transformation can develop early in ICAD patients without preceding treatment with antithrombotic agents. Clinicians are urged to use antithrombotic agents with caution in patients with spontaneous ICAD with ischemic stroke because early hemorrhagic transformation may also be present. Possible pathomechanisms and treatment strategies are also discussed.
authors.affiliation: Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
authors.forename: Ju-Sing
authors.initials: JS
authors.lastname: Fan
authors.forename: Feng-Chi
authors.initials: FC
authors.lastname: Chang
authors.forename: Han-Hwa
authors.initials: HH
authors.lastname: Hu
authors.forename: Li-Chi
authors.initials: LC
authors.lastname: Hsu
mesh_terms: D000328:Adult; D020215:Carotid Artery, Internal, Dissection / Q000150:complications* / Q000175:diagnosis; D002543:Cerebral Hemorrhage / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020521:Stroke / Q000209:etiology*