EAN 2023 | An autopsy study investigating hemorrhagic transformation in stroke

Laszlo Csiba, MD, PhD, DSci, University of Debrecen, Debrecen, Hungary, discusses new findings from body and brain autopsy of 700 stroke patients with and without thrombolysis. Ischemic stroke requires appropriate therapy, mainly through vessel-opening techniques like thrombolysis and mechanical thrombectomy. However, these interventions can lead to hemorrhagic transformation, a frequent complication of acute ischemic stroke that is especially common after thrombolytic therapy. A study conducted autopsies on patients who died after the intervention to determine the frequency and parameters influencing this complication. Surprisingly, the study revealed that more patients experienced hemorrhagic transformation between thrombolysis and death rather than during the first day. These results suggest that thrombolysis is not the main factor influencing hemorrhagic transformation since the half-life of alteplase is only some minutes. Therefore, hemorrhagic transformation between the first day and death was influenced by other factors. Understanding the factors influencing this complication, such as glucose levels and blood pressure, is crucial to preventing negative outcomes. This interview took place at the European Academy of Neurology (EAN) 2023 Congress in Budapest, Hungary.

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