Reimann M, Niehaus L, Lehmann R
Abteilung für Neuroradiologie, Medizinische Fakultät der Humboldt-Universität zu Berlin.
Rofo. 2000 Aug;172(8):675-9. doi: 10.1055/s-2000-7170.
To describe the incidence, time course, and clinical correlates of hemorrhagic transformation (HT) of ischemic stroke in the posterior cerebral artery territory.
Within 42 months 48 patients with 52 occipital lobe infarctions were examined by T1- and T2-weighted MR imaging. The extent and distribution of secondary hemorrhage were analysed at different intervals after stroke. Volume of ischemic and hemorrhagic infarction was measured planimetrically.
HT was observed in 71% of the infarcts between the 5th day and up to 1 year after stroke. HT was most frequently (88%) observed in the 2nd and 3rd month. HT was present in 55% of small infarcts (< 10 cm3), in 88% of medium size (10-50 cm3), and in all large (> 50 cm3) infarcts. In 92% HT presented with petechial bleedings within the cortex (64%) or less frequently (28%) in subcortical structures. The latter types of HT showed no progression and did not increase the clinical deficits. Space-occupying bleedings occurred in only two large defects.
In ischemic posterior infarction, HT can frequently be detected within the first three months after stroke and is predominantly of the petechial type and seems not to be relevant with regard to clinical deficits.
描述大脑后动脉区域缺血性卒中出血性转化（HT）的发生率、时间进程及临床相关因素。
在42个月内，对48例患有52次枕叶梗死的患者进行T1加权和T2加权磁共振成像检查。在卒中后的不同时间间隔分析继发性出血的范围和分布。用面积测量法测量缺血性梗死和出血性梗死的体积。
在卒中后第5天至1年期间，71%的梗死灶出现HT。HT最常见于（88%）第2和第3个月。小梗死灶（<10 cm³）中55%出现HT，中等大小梗死灶（10 - 50 cm³）中88%出现HT，所有大梗死灶（>50 cm³）均出现HT。92%的HT表现为皮质内瘀点出血（64%），或较少见（28%）于皮质下结构。后一种类型的HT无进展，也未增加临床缺损。仅在两个大梗死灶中出现占位性出血。
在缺血性后循环梗死中，卒中后前三个月内常可检测到HT，且主要为瘀点型，似乎与临床缺损无关。
