The haemorrhagic transformation of cerebral infarction: Classification, pathogenesis, predictors and effect on the functional outcome

Abstract

© 2019 Sovero Press Publishing House. All rights reserved. Using specific keywords, we searched for articles from the last 10 years on haemorrhagic transformation (HT) of cerebral infarction (CI), which were available on the PubMed database. This article provides an analysis and a summary of the information on the classification, pathogenesis and predictors (clinical, laboratory, neuroimaging, including the use of integrative assessment scales) of HT, as well as its impact on the functional outcome of the condition. It is emphasized that HT is a multifactorial pathological process in its phenomenology, including brain ischaemia, the development of coagulopathy, disturbances in the integrity of the blood–brain barrier and reperfusion injury. The emphasis is placed on careful monitoring of patients with acute ischaemic infarct after intravenous thrombolytic therapy and/or endovascular intervention, as well as those patients with a high predicted risk of HT. Timely and regular neuroimaging should be carried out to detect HT as soon as possible. Type 2 parenchymal haematomas, the most severe type of HT, are most often associated with high mortality and an unfavourable functional outcome.