Clinical analysis of spontaneous hemorrhagic transformation in 33 cases with acute cerebral infarction

Objective To investigate the clinical features,imaging characteristics,therapy and prognosis of spontaneous hemorrhagic transformation(HT) after cerebral infarction.Methods Retrospective analysis was performed in 422 patients with acute ischemic stroke patients admitted in our hospital between July 2011 and July 2012.Of the patients,33(19 male and 14 female) occurred spontaneous hemorrhagic transformation and were reviewed regarding of clinical performance,MR and CT imaging findings as well as treatment.According to the occurrence time of hemorrhage transformation,the patients were divided into early-onset HT group(18 cases) and late-onset HT group(15 cases).The clinical characteristics and prognosis were compared between the two groups.Results The rate of HT was 7.82%.Most of the HT occurred within 7d.Bleeding sites were located in the center or around the infarct area.The most cases were cerebral cortex hemorrhage.The spontaneous HT was less,that may not aggravate neurological function defect after actively adjust the treatment.The prognosis was not significantly different between the early-onset HT group and late-onset HT groups.Conclusion Repeat brain CT should be performed for a patient with high risk of HT,and adjust the therapy in time.However,fibrinolysinum may increase the incidence of the late-onset HT.