Haemorrhagic transformation in cardioembolic stroke
The article reveales that the number of female patients dominated over male ones in the group of urgently admitted stroke patients in a six month period (60,6% and 39,4%, respectively). Women prevailed in the group of 20–30-years old patients (2,6 times higher than men), but quantity of male patients rose sharply among 30–40-years old ones (5 times higher than women). In other age groups (40–50, 50–60 and 60–70 years old) men also predominated, whereas among 70-80-years old people more women were admitted (1,2 times higher than men), and this ratio was 4,8 times higher among patients aged over 80 years old. Among stroke patients admitted to hospital aged under 60 years old there were 36% male patients and 19,5% female ones (from total number of admitted), which is indicative of stroke “youthification” mainly due to men. A group of patients with haemorrhagic transformation (HT) of ischaemic stroke was separated from stroke patients urgently admitted to Saint Petersburg Djanelidze Research Institute of Emergency Medicine and then analyzed. We found out that HT occured more often in older patients with cardioembolic stroke on the 2nd-4th days after disease onset. It was accompanied by deterioration of neurological symptoms and confirmed by neuroimaging. Following risk factors of HT were revealed: large lesion size, predominantly in the left medial cerebral artery circulation; an incomplete circle of Willis together with dilated ventricles and oft en midline shift of the brain; heart rhythm disturbance, especially atrial fi brillation; hypertension in ischaemic stroke; low prothrombin ratio.