Hyperintense acute reperfusion marker on FLAIR is not associated with early haemorrhagic transformation in the elderly.

European Radiology
Michal RozanskiJochen B Fiebach

Abstract

The hyperintense acute reperfusion marker (HARM) has been described as a predictor for haemorrhagic transformation (HT) in acute ischaemic stroke. We hypothesised that this phenomenon is not present in the elderly. It was possible to assess 47/84 consecutive patients aged 80 and over with diagnosed ischaemic stroke or transient ischaemic attack (TIA). MRI was performed within 24 h of onset of symptoms with follow-up MRI within a further 48 h. Of 47 included patients, 19 showed HARM; it was only seen on follow-up examination. Ten of the 47 patients underwent thrombolysis with recombinant tissue plasminogen activator (rt-PA); 4 of them showed HARM, and 1 of those showed HT. HARM was found in three out of eight patients with haemorrhagic transformation on baseline and/or follow-up MRI. We did not observe an association between HARM and early HT either in the whole group or in the patients who received thrombolysis. HARM was not associated with HT in the elderly after ischaemic stroke, independent of treatment. While it may indicate dysfunction of the blood-brain barrier (BBB), it does not necessarily amount to HT.

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Citations

Aug 25, 2012·AJNR. American Journal of Neuroradiology·J G MerinoS Warach
Mar 25, 2016·AJR. American Journal of Roentgenology·Kyung Mi LeeHee-Joon Bae
Apr 30, 2016·Case Reports in Radiology·Alex FörsterChristoph Groden
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Dec 30, 2016·Neurology·Kersten VillringerJochen B Fiebach
Apr 10, 2021·Journal of Neuroradiology. Journal De Neuroradiologie·A FörsterA Alonso

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