Hemorrhagic transformation of stroke secondary to spontaneous internal carotid artery dissection.
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.
Fan
Ju-Sing
JS
Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
Chang
Feng-Chi
FC
Hu
Han-Hwa
HH
Hsu
Li-Chi
LC
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*