Journal article

Postthrombolysis Blood Pressure Elevation Is Associated With Hemorrhagic Transformation

Kenneth Butcher, Soren Christensen, Mark Parsons, Deidre A De Silva, Martin Ebinger, Christopher Levi, Thomas Jeerakathil, Bruce CV Campbell, P Alan Barber, Christopher Bladin, John Fink, Brian Tress, Geoffrey A Donnan, Stephen M Davis



BACKGROUND AND PURPOSE: Reliable predictors of hemorrhagic transformation (HT) after stroke thrombolysis have not been identified. We analyzed hemorrhage in a randomized trial of tissue plasminogen activator (t-PA) vs placebo in ischemic stroke patients. We hypothesized that acute diffusion-weighted imaging (DWI) lesion volumes would be larger and blood pressures would be higher in patients with HT. METHODS: HT was assessed 2 to 5 days after treatment in 97 patients. Hemorrhage was assessed by using susceptibility-weighted imaging sequences and was classified as petechial hemorrhagic infarction (HI) or parenchymal hematoma (PH). RESULTS: PH was more frequent in t-PA- (11/49) than in placebo-..

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