Department of Neurology, Center for Stroke Research Berlin-CSB, Charité, Universitätsmedizin Berlin, Berlin, Germany.
Eur Radiol. 2010 Dec;20(12):2990-6. doi: 10.1007/s00330-010-1881-9. Epub 2010 Jul 21.
The hyperintense acute reperfusion marker (HARM) has been described as a predictor for haemorrhagic transformation (HT) in acute ischaemic stroke. We hypothesised that this phenomenon is not present in the elderly.
It was possible to assess 47/84 consecutive patients aged 80 and over with diagnosed ischaemic stroke or transient ischaemic attack (TIA). MRI was performed within 24 h of onset of symptoms with follow-up MRI within a further 48 h.
Of 47 included patients, 19 showed HARM; it was only seen on follow-up examination. Ten of the 47 patients underwent thrombolysis with recombinant tissue plasminogen activator (rt-PA); 4 of them showed HARM, and 1 of those showed HT. HARM was found in three out of eight patients with haemorrhagic transformation on baseline and/or follow-up MRI. We did not observe an association between HARM and early HT either in the whole group or in the patients who received thrombolysis.
HARM was not associated with HT in the elderly after ischaemic stroke, independent of treatment. While it may indicate dysfunction of the blood-brain barrier (BBB), it does not necessarily amount to HT.
高信号急性再灌注标志物（HARM）已被描述为急性缺血性卒中发生出血性转化（HT）的预测因子。我们假设这种现象在老年人中并不存在。
对 80 岁及以上连续确诊为缺血性卒中和短暂性脑缺血发作（TIA）的 84 例患者中的 47 例进行了评估。MRI 在症状发作后 24 小时内进行，并在随后的 48 小时内进行了进一步的 MRI 随访。
47 例纳入患者中，19 例出现 HARM；仅在随访检查中可见。47 例患者中有 10 例接受重组组织型纤溶酶原激活剂（rt-PA）溶栓治疗；其中 4 例出现 HARM，其中 1 例出现 HT。在基线和/或随访 MRI 上有 3 例出现 HT 的患者中，HARM 为 3 例。我们未观察到 HARM 与整个组或接受溶栓治疗的患者的早期 HT 之间存在关联。
在缺血性卒中后，无论是否接受治疗，HARM 与老年人的 HT 均无关联。虽然它可能表明血脑屏障（BBB）功能障碍，但不一定等同于 HT。
