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pubmed-article:15358958pubmed:abstractTextHyperacute, spontaneous, and severe parenchymal postischemic hemorrhage is considered rare but might be frequently misdiagnosed as primary intracerebral hemorrhage. The authors report 2 patients with catastrophic postischemic hemorrhage unrelated to anticoagulation, thrombolytics, or coagulopathy. Patient 1 was a 73-year-old woman with left posterior frontal lobe infarction, followed at 5.5 hours by massive postischemic hemorrhage leading to death. Patient 2 was a 52-year-old man with recent brain irradiation who developed left middle cerebral artery occlusion and basal ganglia infarction. Initial gradient-echo magnetic resonance imaging (MRI) showed petechial hemorrhage within areas of infarction and widespread old microbleeds. He developed massive postischemic hemorrhage at 12 hours, leading to death. The authors conclude that early brain imaging is essential to distinguish postischemic from primary brain hemorrhage. In patients with ischemic stroke, MRI findings such as hyperacute petechial hemorrhage or chronic cerebral microbleeds might predict subsequent parenchymal hemorrhage and thus have implications for tissue plasminogen activator use.lld:pubmed
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pubmed-article:15358958pubmed:authorpubmed-author:SmithEric EEElld:pubmed
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pubmed-article:15358958pubmed:dateRevised2007-11-14lld:pubmed
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pubmed-article:15358958pubmed:year2004lld:pubmed
pubmed-article:15358958pubmed:articleTitleSpontaneous hyperacute postischemic hemorrhage leading to death.lld:pubmed
pubmed-article:15358958pubmed:affiliationDepartment of Neurology, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. eesmith@partners.orglld:pubmed
pubmed-article:15358958pubmed:publicationTypeJournal Articlelld:pubmed
pubmed-article:15358958pubmed:publicationTypeResearch Support, U.S. Gov't, P.H.S.lld:pubmed
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