Intracranial Bleeding After Reperfusion Therapy in Acute Ischemic Stroke.
Fiche publication
Date publication
janvier 2020
Journal
Frontiers in neurology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr MOULIN Thierry
Tous les auteurs :
Charbonnier G, Bonnet L, Biondi A, Moulin T
Lien Pubmed
Résumé
Intracranial hemorrhage is one of the most feared complications following brain infarct. Ischemic tissues have a natural tendency to bleed. Moreover, the first recanalization trials using intravenous thrombolysis have shown an increase in mild to severe intracranial hemorrhage. Symptomatic intracerebral hemorrhage is strongly associated with poor outcomes and is an important factor in recanalization decisions. Stroke physicians have to weigh the potential benefit of recanalization therapies, first, with different risks of intracranial hemorrhage described in randomized controlled trials, and second with numerous risk markers that have been found to be associated with intracranial hemorrhage in retrospective series. These decisions have become quite complex with different intravenous thrombolytics and mechanical thrombectomy. This review aims to outline some elements of the pathophysiological mechanisms and classifications, describe most of the risk factors identified for each reperfusion therapy, and finally suggest future research directions that could help physicians dealing with these complications.
Mots clés
brain hemorrhage, hemorrhagic transformation, intracranial bleeding, intravenous thrombolysis, mechanical thrombectomy, reperfusion, stroke
Référence
Front Neurol. 2020 ;11:629920