HEMORRHAGIC TRANSFORMATION IN CARDIOEMBOLIC CEREBRAL INFARCTION
HEMORRHAGIC TRANSFORMATION IN CARDIOEMBOLIC CEREBRAL INFARCTION
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DOI：
10.1161/01.str.24.3.465
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发表时间：
1993-03-01
期刊：
影响因子：
8.3
通讯作者：
DORNDORF, W
中科院分区：
文献类型：
--
作者：
HORNIG, CR;BAUER, T;DORNDORF, W
背景和目的：由于脑梗塞出血转化的频率仍然存在争议，我们对一系列连续的心源性脑卒中患者进行了前瞻性磁共振成像研究。 综述总结：在 200 名连续的短暂性脑缺血发作或缺血性脑卒中患者中，41 例经计算机断层扫描证实为心源性栓塞导致的幕上梗塞。中风后 3 周，对这 41 名患者中的 35 名进行了磁共振成像（T1 加权）检查。八名患者接受了抗凝剂治疗。磁共振图像显示，35 例梗塞中有 68.6%（24 例）出现出血性转化，但临床症状始终没有恶化。在逐步向前逻辑回归分析中，只有初始计算机断层扫描上的梗塞水肿体积与出血转化的风险显着相关（p = 0.037）。出血是梗塞体积超过 10 cm3 的磁共振图像的常见发现（94.4%，18 例中的 17 例）。结论：出血转化是中型和大型心源性梗塞的常见发现。因此，在急性中风的治疗和预防研究中，应该关注的是脑梗塞出血的严重程度，而不是频率。
Background and Purpose: Because the frequency of hemorrhagic transformation of cerebral infarcts is still a matter of controversy, we performed a prospective magnetic resonance imaging study in a series of consecutive patients with cardioembolic stroke.Summary of Review: Among 200 consecutive patients with transient ischemic attack or ischemic stroke, 41 were identified with a computed tomographically proven supratentorial infarct due to cardiogenic embolism. Magnetic resonance imaging (T1-weighted) was performed 3 weeks after the stroke in 35 of these 41 patients. Eight patients received anticoagulants. Magnetic resonance images showed hemorrhagic transformation in 68.6% (24) of the 35 infarcts, always without clinical deterioration. In a stepwise forward logistic regression analysis only the volume of infarction edema on the initial computed tomogram was linked significantly with the risk of hemorrhagic transformation (p = 0.037). Hemorrhages were a regular finding on magnetic resonance images of infarcts exceeding a volume of 10 cm3 (94.4%, 17 of 18).Conclusions: Hemorrhagic transformation is a regular finding in medium-sized and large cardioembolic infarcts. Thus, in therapeutic and preventive studies of acute stroke the severity, not the frequency, of hemorrhages into brain infarcts should be the matter of interest.