{macro question(showVoteTotal)}
    <div class="poll-question">
      {if keyType == "discussion"}
        <a href="/forums/?plckForumPage=ForumDiscussion&plckDiscussionId=${key}#forumPostTitle_1" title="View discussion">
          ${poll.Question}
        </a>
      {else}
        ${poll.Question}
      {/if}
      {if showVoteTotal}
        <span class="poll-votes">(${poll.TotalVotes} ${"vote"|pluralise:poll.TotalVotes})</span>
      {/if}
    </div>
  {/macro}
  <div class="slResults" {if !noVote}style="display:none;"{/if}>
    ${question(true)}
    <table class="slAnswerStats" cellpadding="0" cellspacing="0" border="0">
      {for answer in poll.Answers}
        <tr class="slAnswerStat slAnswerStat_${answer_index}">
          <td class="slAnswer">${answer.Answer}</td>
          <td class="slAnswerBarCell">
            <div class="slAnswerBar">
              <div class="slAnswerCount">${answer.NumberOfVotes} ${"vote"|pluralise:answer.NumberOfVotes} (${answer.PercentageStr}%)</div>
              <div class="slAnswerBarPercent" style="width: ${answer.Percentage}%;"></div>
            </div>
          </td>
        </tr>
      {/for}
    </table>
    {if !noVote}<div class="results"><a href="javascript:void(0);" class="slVoteLink">Go vote!</a></div>{/if}
  </div>

{if !noVote}
  <div class="slVote">
    <div class="slErrorText">You must select one answer before submitting your vote.</div>
    ${question(false)}
    <table class="slAnswers" cellspacing="0" cellpadding="0" border="0">
      {for answer in poll.Answers}
        {var answerId = poll.PollKey.Key + '.' + answer_index}
        <tr>
          <td class="slAnswerInput">
            <input type="radio" name="answers" value="${answer_index}" id="${answerId}"/>
          </td>
          <td class="slAnswerText">
            <label for="${answerId}">${answer.Answer}</label>
          </td>
        </tr>
      {/for}
    </table>
    <div style="clear: both; margin-left: 8px;">
      <div class="slSendAnswer"><input class="slVoteButton" type="button" value="Vote" /></div>
      <div class="results"><a href="javascript:void(0);" class="slResultsLink">View Results...</a></div>
    </div>
  </div>
  {/if}

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Haemorrhagic transformation or bleed after thrombolysing ischaemic stroke?

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Stroke

Haemorrhagic transformation or bleed after thrombolysing ischaemic stroke?

Read and join discussion threads related to stroke medicine

One of the issues that I faced recently when I was on call for thrombolysing stroke patients in Gwent, is that: seventy five years old woman was admitted within the thrombolysing time window after a

0

Cat:OpenClinicalForum:cdb59579-d995-4f9f-b0a7-85795a3c694e

Cat:OpenClinicalForum:cdb59579-d995-4f9f-b0a7-85795a3c694eDiscussion:1d362af1-89f5-4834-ae9f-5517f60d8b82

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Forums » Open clinical » Stroke » Haemorrhagic transformation or bleed after thrombolysing ischaemic stroke?

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Forums » Open clinical » Stroke » Haemorrhagic transformation or bleed after thrombolysing ischaemic stroke?

Haemorrhagic transformation or bleed after thrombolysing ischaemic stroke?

posted at 5/11/2011 10:25 PM GMT on bmj.com

Amer Jafar

Posts: 53
First: 19/7/2011
Last: 11/3/2013

One of the issues that I faced recently when I was on call for thrombolysing stroke patients in Gwent, is that: seventy five years old woman was admitted within the thrombolysing time window after a collapse and left sided weakness. Her CT brain showed acute clot in the Rt MCA (Middle cerebral artery). I immediately thrombolysed the patient. Her CT scan which was requested as part of our 24hours follow up (Which we might not need but it was done any way) showed brain haemorrhage at the area of the infarction with slight mass effect. The question is whether this haemorrhage represents the transformation of the ischaemia or a true reaction to the thrombolysis? We know from experience that acute thrombus in the MCA make the area more vulnerable to bleed.

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Re: Haemorrhagic transformation or bleed after thrombolysing ischaemic stroke?

posted at 6/11/2011 10:57 AM GMT on bmj.com

yoram chaiter

Posts: 1790
First: 7/3/2009
Last: 24/5/2013

Did the patient have diabetes? Unfortunately diabetic patients tend to have frail blood vessels, so an ischemic stroke thrombolysed can easily turn into a hemorrhagic one.

Hemorrhage can happen also among non diabetic patients and it is unfortunately a complication that can occur when thromolysis is used. How is the patient doing?Did she require neurosurgical intervention?

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Re: Haemorrhagic transformation or bleed after thrombolysing ischaemic stroke?

posted at 6/11/2011 11:34 PM GMT on bmj.com

Amer Jafar

Posts: 53
First: 19/7/2011
Last: 11/3/2013

She is not diabetic. She remains unwell. The surgeons adviced for conservative management. The risk of surgery in her age group is high.

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Re: Haemorrhagic transformation or bleed after thrombolysing ischaemic stroke?

posted at 8/11/2011 3:59 PM GMT on bmj.com

Amer Jafar

Posts: 53
First: 19/7/2011
Last: 11/3/2013

Today, she looks better and more communicative but she remains without any antiplatelet medication.

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Re: Haemorrhagic transformation or bleed after thrombolysing ischaemic stroke?

posted at 8/11/2011 10:05 PM GMT on bmj.com

yoram chaiter

Posts: 1790
First: 7/3/2009
Last: 24/5/2013

You can only wait now and monitor closely. And hope for the resolution of that hemorrhage. Hopefully she won't develop more complications such as hydrocephalus due to problems in CSF drainage or brain tissue oedema.

Primum non nocere....

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Re: Haemorrhagic transformation or bleed after thrombolysing ischaemic stroke?

posted at 17/7/2012 6:34 PM BST on bmj.com

neuromedicine

Posts: 312
First: 2/6/2012
Last: 10/5/2013

risk for haeorrhagic tranformation is large infarct, uncontroled bp, violent or restless patient more likely developed HT.

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Forums » Open clinical » Stroke » Haemorrhagic transformation or bleed after thrombolysing ischaemic stroke?