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Hemorrhagic Transformation in Stroke Patients

Bayramoğlu, Meral MD; Karataş, Metin MD; Leblebici, Berrin MD; Çetin, Nuri MD; Sözay, Seyhan MD; Turhan, Nur MD

American Journal of Physical Medicine & Rehabilitation: January 2003 - Volume 82 - Issue 1 - p 48-52
Research Article: Stroke

Bayramoğlu M, Karataş M, Leblebici B, Çetin N, Sözay S, Turhan N: Hemorrhagic transformation in stroke patients. Am J Phys Med Rehabil 2003;82:48–52.

Objective To identify the predictors of hemorrhagic transformation in stroke patients and to evaluate the impact of hemorrhagic transformation on rehabilitation outcome.

Design The records of 203 hemiplegic patients hospitalized for rehabilitation after the acute phase of stroke were retrospectively analyzed. In 121 cases, the first computed tomographic scan and a repeat scan were compared to determine whether hemorrhagic transformation occurred. Correlations between the occurrence of hemorrhagic transformation and use of anticoagulants, antiaggregants, and antiedema drugs were evaluated. Admission and discharge FIM™ and Adapted Patient Evaluation Conference System scores were noted, and functional gain was calculated from these. These data were also analyzed for associations with hemorrhagic transformation.

Results Hemorrhagic transformation was detected in 39 of the 121 cases. There was no significant difference in functional outcome between patients who did and did not show hemorrhagic transformation. Although not statistically significant, the use of antiedema drugs was found to increase the risk of hemorrhagic transformation, whereas the use of anticoagulants and antiaggregants had no influence.

Conclusions Hemorrhagic transformation of an ischemic lesion does not affect rehabilitation outcome in stroke survivors. The study results favor the use of anticoagulants and antiaggregants in the acute phase unless these drugs are contraindicated by the patient’s condition. Still, prospective trials are needed to make definite conclusions.

From the Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Başkent University, Ankara, Turkey.

FIM™ is a trademark of the Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc.

All correspondence and requests for reprints should be addressed to Meral Bayramoğlu, MD, Başkent University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, 16 Sokak No: 11, Bahçelievler 06490, Ankara, Turkey.

© 2003 Lippincott Williams & Wilkins, Inc.