What is hemorrhagic transformation (hemorrhagic conversion)?
Hemorrhagic transformation (HT) is a frequent complication of acute ischemic stroke that is especially common after thrombolytic therapy.
The risk of HT limits the applicability of tissue plasminogen activator (tPA).
Hemorrhagic transformation (HT), which refers to a spectrum of ischemia-related brain hemorrhage, is a frequent spontaneous complication of ischemic stroke, especially after thrombolytic therapy.
Therefore, HT limits the use of tissue plasminogen activator (tPA) treatment, the only method of clinical management of acute ischemic stroke.
Ischemic strokes can develop a hemorrhagic component, especially if they are large or if the degree of ischemia is severe.
This hemorrhagic transformation occurs because all tissue downstream of an ischemic stroke becomes ischemic—brain and vasculature. In many cases, blood flow to the ischemic area is reestablished too late to benefit the brain and returns via weakened, damaged vessels.
These vessels may leak, resulting in petechial hemorrhage, or burst, resulting in a hematoma.
