Journal of the Chinese Medical Association
Volume 69, Issue 12 , Pages 585-588, December 2006

Hemorrhagic Transformation of Stroke Secondary to Spontaneous Internal Carotid Artery Dissection

  • Ju-Sing Fan

      Affiliations

    • Department of Emergency Medicine, Taipei Veterans General Hospital, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Feng-Chi Chang

      Affiliations

    • Department of Radiology, Taipei Veterans General Hospital, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Han-Hwa Hu

      Affiliations

    • Department of Neurological Institute, Taipei Veterans General Hospital, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Li-Chi Hsu

      Affiliations

    • Department of Neurological Institute, Taipei Veterans General Hospital, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Li-Chi Hsu, Neurological Institute, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.

Received 18 April 2006; accepted 18 October 2006.

The clinical course of patients with hemorrhagic transformation in stroke secondary to spontaneous cervical internal carotid artery dissection (ICAD) has not been elucidated. We report a 36-year-old man with presentation of headache and subsequent left hemiparesis. Magnetic resonance imaging disclosed right ICAD with nearly complete occlusion of the right distal internal carotid artery and infarction over the right basal ganglion with hemorrhagic transformation in its central area. Hemorrhagic transformation can develop early in ICAD patients without preceding treatment with antithrom-botic agents. Clinicians are urged to use antithrombotic agents with caution in patients with spontaneous ICAD with ischemic stroke because early hemorrhagic transformation may also be present. Possible pathomechanisms and treatment strategies are also discussed.

Key Words:  hemorrhagic transformation , internal carotid artery dissection

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PII: S1726-4901(09)70334-X

doi:10.1016/S1726-4901(09)70334-X

Journal of the Chinese Medical Association
Volume 69, Issue 12 , Pages 585-588, December 2006

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