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001-es BibID:	BIBFORM069541
Első szerző:	László János Marcell
Cím:	Hemorrhagic transformation of ischemic stroke / László János Marcell, Hortobágyi Tibor
Dátum:	2017
Megjegyzések:	The better understanding of the diverse mechanisms leading to the hemorrhagic transformation of an ischemic stroke is the crucial point in the prevention of this altogether common phenomenon. The different individual risk factors include the anatomical variability of collateral blood supply, age, genetics, body weight, etiology of the occlusion, side of the occluded vessel, renal status, stroke severity, history of high serum glucose or hypertension and hypertension or hyperglycemia at theonset of the stroke, ferritin level, INR, antiplatelet usage or the platelet count etc. All these might contribute to the process of hemorrhagic transformation. These risk factors have been identified by retrospective epidemiological studies and are useful to identify patients who are at high risk for hemorrhagic conversion and help the decision between conservative, thrombolytic or more advanced treatments such as thrombectomy. The modulations of potential molecular targets participating in the process seem to be promising in animal models, but human trials are lacking the breakthrough success so far, both in extending the time frame of the thrombolysis and in replacing the recombinant tissue plasminogen activator (rtPA) as thrombolytic agent. So far, the careful preselection of patients eligible for thrombolytic therapy is the best way to prevent hemorrhagic transformation. The intensive research in the fieldrevealing small but important molecular details are continuously contributing to the better understanding of hemorrhagic transformation with the intention of findingnew agents that co-administrated to the rtPA or completely replacing that could decrease the risk of secondary bleeding.The aim of this review is to give comprehensive insight into the process of hemorrhagic transformation of ischemic stroke, starting with basic overview of thepenumbra concept and the collateral supply followed by discussion of the recanalisation-reperfusion-hemorrhagic transformation process after vessel occlusion also highlighting the importance of timing and ratio of recanalisation spontaneously and in case of thrombolytic agent administration. We overview the risk factors of hemorrhagic transformation, which may be helpful to physicians to identify high risk patients before rtPA administration. The last part of the work is dealing withfuture therapeutic possibilities based on the so far revealed molecular mechanisms of hemorrhagic transformation.
Tárgyszavak:	Orvostudományok Elméleti orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban stroke HEMORRHAGIC TRANSFORMATION blood-brain barrier risk factors molecular background
Megjelenés:	Vascular Diseases and Therapeutics. - 2 : 4 (2017), p. 1-25. -
További szerzők:	Hortobágyi Tibor (1965-) (patológus)
Pályázati támogatás:	KTIA_13_ NAP-A-II/7 Egyéb GINOP-2.3.2-15-2016-00043 GINOP
Internet cím:	DOI Intézményi repozitóriumban (DEA) tárolt változat
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