Katramados Angelos M, Hacein-Bey Lotfi, Varelas Panayiotis N
Department of Neurology, Wayne State University, Henry Ford Hospital, K-11, 2799 West Grand Boulevard, Detroit, MI 48202, USA.
Interventional Neuroradiology and Neuroradiology, Department of Medical Imaging, Sutter Health, Sacramento, CA 95815, USA; Radiology Department, University of California Davis Medical School of Medicine, 4860 Y Street, Sacramento, CA 95817, USA.
Neuroimaging Clin N Am. 2018 Nov;28(4):649-662. doi: 10.1016/j.nic.2018.06.007. Epub 2018 Sep 15.
The most feared complication after acute ischemic stroke is symptomatic or asymptomatic hemorrhagic conversion. Neuroimaging and clinical criteria are used to predict development of hemorrhage. Seizures after acute ischemic stroke or stroke-like symptoms from seizures are not common but may lead to confusion in the peristroke period, especially if seizures are repetitive or evolve into status epilepticus, which could affect neuroimaging findings. Malignant infarction develops when cytotoxic edema is large enough to lead to herniation and death. Post-stroke neuroimaging prognosticators have been described and should be assessed early so that appropriate treatment is offered before herniation leads to additional tissue injury.
急性缺血性卒中后最令人担忧的并发症是有症状或无症状的出血性转化。神经影像学和临床标准用于预测出血的发生。急性缺血性卒中后出现癫痫发作或癫痫发作引起的类似卒中症状并不常见，但可能在卒中发作期导致意识模糊，尤其是癫痫发作反复出现或发展为癫痫持续状态时，这可能会影响神经影像学检查结果。当细胞毒性水肿大到足以导致脑疝和死亡时，就会发生恶性梗死。已经描述了卒中后神经影像学预后指标，应尽早进行评估，以便在脑疝导致额外组织损伤之前提供适当的治疗。
