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- Title
Predictive Factors of Hemorrhagic Transformation in Acute Ischemic Stroke.
- Authors
El-Khawas, Hala M.; El-Rakawy, Mahmoud H.; Zakaria, Magd F.; Tantawy, Wahid H.; Raafat, Mona A.; Fouad, Mohammed M.
- Abstract
Background: The risk of hemorrhagic transformation (HT) after cerebral ischemia is a major problem. There are no firm prognostic criteria to predict the risk of HT after the ischemic event. Objective: The aim of this study was to investigate the predictive factors of HT in acute ischemic stroke. Methods: Consecutive patients admitted with acute cerebral infarction were recruited and submitted to clinical evaluation including National Institute of Health Stroke Scale (NIHSS), laboratory investigations, baseline computed tomography (CT) scan, magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA), follow up CT scan within one week from onset. Results: Forty nine patients out of 324 patients (15.1%) with ischemic stroke developed HT. Patients with HT had higher NIHSS score (P=0.001), larger volume of infarction (P=0.001), more prevalent early ischemic changes in baseline CT (P=0.001), microbleeds and significant intracranial arterial stenosis in MRA (P=0.001). Also, HT patients tended to have higher levels of random blood sugar (RBS) (P=0.0001), higher total leukocyte count (TLC) (P=0.002), higher values of international normalized ratio (INR) (P=0.02), and lower cholesterol levels (P=0.002). AF and cardioembolic stroke were more common among patients who developed HT (P=0.001). Conclusion: Cardioembolic stroke, stroke attributable to large artery atherosclerosis, AF, large infarction size, microbleeds, high RBS and INR on admission are independent predictors of HT.
- Subjects
STROKE treatment; CEREBRAL ischemia; CEREBRAL infarction; NATIONAL Institutes of Health (U.S.); COMPUTED tomography; MAGNETIC resonance imaging; MAGNETIC resonance angiography
- Publication
Egyptian Journal of Neurology, Psychiatry & Neurosurgery, 2012, Vol 49, Issue 3, p181
- ISSN
1110-1083
- Publication type
Article