Annals of Clinical and Experimental NeurologyAnnals of Clinical and Experimental NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-2533Eco-Vector59110.25692/ACEN.2019.2.6ReviewsОбзорыUnknownThe haemorrhagic transformation of cerebral infarction: classification; pathogenesis; predictors and effect on the functional outcomeГеморрагическая трансформация инфаркта мозга: классификация, патогенез, предикторы и влияние на функциональный исходKhasanovaDina R.ХасановаДина Рустемовна
Russian Federation
ninilak@gmail.comKalininMikhail N.КалининМихаил Николаевич
Russian Federation
ninilak@gmail.comIbatullinМurat M.ИбатуллинМурат Масгутович
Russian Federation
ninilak@gmail.comRakhimovIlnur Sh.РахимовИльнур Шавкатович
Russian Federation
ninilak@gmail.comKazan State Medical UniversityФГБОУ ВО «Казанский государственный медицинский университет»Interregional Clinical Diagnostic CentreГАУЗ "Межрегиональный клинико-диагностический центр"Elabuga Institute (Branch) of the Kazan (Volga Region) Federal UniversityЕлабужский институт (филиал) ФГАОУ ВО «Казанский (Приволжский) федеральный университет»25062019132475925062019Copyright ©; 2019, Khasanova D.R., Kalinin M.N., Ibatullin М.M., Rakhimov I.S.Copyright ©; 2019, Khasanova D.R., Kalinin M.N., Ibatullin М.M., Rakhimov I.S.2019Khasanova D.R., Kalinin M.N., Ibatullin М.M., Rakhimov I.S.Khasanova D.R., Kalinin M.N., Ibatullin М.M., Rakhimov I.S.https://creativecommons.org/licenses/by/4.0https://annaly-nevrologii.com/pathID/article/view/591

Using specific keywords; we searched for articles from the last 10 years on haemorrhagic transformation (HT) of cerebral infarction (CI); which were available on the PubMed database. This article provides an analysis and a summary of the information on the classification; pathogenesis and predictors (clinical; laboratory; neuroimaging; including the use of integrative assessment scales) of HT; as well as its impact on the functional outcome of the condition. It is emphasized that HT is a multifactorial pathological process in its phenomenology; including brain ischaemia; the development of coagulopathy; disturbances in the integrity of the blood–brain barrier and reperfusion injury. The emphasis is placed on careful monitoring of patients with acute ischaemic infarct after intravenous thrombolytic therapy and/or endovascular intervention; as well as those patients with a high predicted risk of HT. Timely and regular neuroimaging should be carried out to detect HT as soon as possible. Type 2 parenchymal haematomas; the most severe type of HT; are most often associated with high mortality and an unfavourable functional outcome.

Используя специальные ключевые слова, мы провели поиск статей за последние 10 лет, посвященных геморрагической трансформации (ГТ) ишемического инсульта (ИИ) и доступных в базе данных PubMed. В статье проанализированы и обобщены сведения по классификации, патогенезу, предикторам ГТ (клиническим, лабораторным, нейровизуализационным, в том числе с использованием интегративных оценочных шкал), а также о влиянии ГТ на функциональный исход болезни. Подчеркивается, что по своей феноменологии ГТ является многофакторным патологическим процессом, включающим ишемию мозга, развитие коагулопатии, нарушение целостности гематоэнцефалического барьера и реперфузионное повреждение. Сделан акцент на тщательном мониторинге пациентов с острым ИИ после внутривенной тромболитической терапии и/или эндоваскулярного вмешательства, а также больных с высоким прогнозируемым риском ГТ. Для скорейшего выявления ГТ следует проводить своевременную и регулярную нейровизуализацию в динамике. Паренхиматозные гематомы 2-го типа, наиболее тяжелый тип ГТ, чаще всего ассоциированы с высокой летальностью и неблагоприятным функциональным исходом.

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