Clinical Predictors and Management of Hemorrhagic Transformation

Hemorrhagic Transformation (HT) has been well recognized as a common cause of hemorrhage in ischemic stroke patients. Though this complication may occur independently, it has been particularly dreaded in the post rTPA patient and thus has been the focus for analysis of multiple thrombolytic trials. This review examines the effect of different clinical predictors for hemorrhagic transformation and summarizes pertinent clinical trials, with a focus on the rational for design of future studies. Although currently there are no official guidelines for the acute management of HT per se, based upon review of the literature regarding pertinent clinical predictors herein, an innovative approach for the acute management of the HT patient is proposed.