| Objective：In this paper, a retrospective analysis of patients with100new cases ofinfarction, according to the head MRI results of50cases of hemorrhagictransformation. Study of50cases of hemorrhagic transformation of imaging features,clinical characteristics, risk factors. Objective to improve the understanding ofdiagnosis, treatment and prognosis of hemorrhagic transformation, the properidentification, also provides new clue for the research of pathogenesis.Methd：Review the clinical data of100cases of cerebral infarction inpatients withsummarizing the Second Clinical Medical College of Jilin University during2012-1-1to2013-2-22, according to whether the secondary hemorrhage, dividedinto hemorrhagic transformation group (HT group)50cases and non hemorrhagictransformation group (NHI group)50cases. Description of the imaging findings,and clinical features. For age, sex, hypertension, respectively (systolic pressure,diastolic pressure), history of diabetes, heart disease, atrial fibrillation, blood lipidindex, cerebral embolism, area of infarction, infarct location, admission bloodglucose, urine protein, whether anticoagulation, thrombolytic agents and14riskfactors were analyzed, including the analysis of single factor analysis and multiplefactors. The use of SPSS17.0software and statistical analysis.Results：1general situation: HT patients were male37, female13patients, the age isthe smallest43years old, the oldest85years old, mean age60.8years old.2Summary: group HT clinical features such as hemiplegia in23cases (46%),2cases of aphasia (4%),5(10%) patients with disturbance of consciousness, headacheand dizziness in9cases (18%),5patients with visual field defects (10%),3cases of psychiatric symptoms (6%), the seizure of2cases (4%), no symptoms of1cases (2%),nausea and vomiting in0cases, common deviation in0cases, and dysphagia in0cases,urinary incontinence in0cases,0cases of ataxia, slow reaction in0cases,0cases and0cases of nystagmus, retest..HT group after hemorrhage clinical symptoms increase7cases, accounting for14%, wherein the expression is recognizant obstacle degreeincrease4cases, accounting for58%. Hemiplegia and headache aggravating1cases,accounting for14%. The new standing instability1cases, accounting for14%. Thenew right facial numbness, vomiting, hoarseness were1cases, accounting for14%.3The1.3time HT incidence and etiology, Cerebral infarction after24hoursof HT19,2days6,3days2,4-7d disease7,8-11days after onset3cases,12-15days2cases, more than15days were9cases,2were uncertain hemorrhagictransformation time. One of the most for a long time30days. The occurrence ofhemorrhagic transformation in15days after infarction78%. According to Adamatyping of cerebral infarction typing standard,50patients, large area cerebralinfarction25cases, small area infarction24cases, lacunar infarction1cases.4Imaging examination:50cases of patients were performed head CT or MRIexamination confirmed the diagnosis of hemorrhagic transformation. CT scanshowed patchy low density shadow with scattered in the non-uniform punctate,patchy high density or large bolus of high density. The head MRI in acute lesionsshow a short T1, short T2signal, subacute lesions with short T1., long T2signal. Theinfarct border small pieces of hemorrhage (34) cases, infarction within a wide rangeof hemorrhage15cases. Hematoma formation but infarction area <30%hematoma1cases, infarction area of>30%0cases of hematoma. FINDINGS: frontal lobeinfarction1cases, occipital lobe4cases, basal ganglia5cases, the cerebellum2cases. The group involved2lobes7cases, those involving the3lobes of the brainwere11cases, a total of4lobes of the brain were3cases, cerebellar lobes1caseswere+,++brainstem cerebellar lobes were1cases, basal ganglia and brainstem+lobes were1cases, basal ganglia (or corona or semicircular Center)+cerebral lobes(9) cases, cerebellar+brainstem were1cases, brain stem and basal ganglia (centrum semiovale) were3cases of basal ganglia, brainstem and cerebellum1cases were+. The total number of cerebral infarction is a single person12patients,most38cases. Type HI1in34cases in group HT,15cases of HI2type,1cases ofPH1type,0cases of PH2type. The symptoms were type HI1in3cases,4cases ofHI2type. HI1, HI2, PH1, the clinical effective rate were88.24%,93.33%,100%.5Risk factors, For age, sex, hypertension, respectively (systolic pressure,diastolic pressure, heart valve disease), atrial fibrillation, blood lipid indexes (TC,LDL-L, a (Lpa)), prothrombin time (fibrinogen), statistical analysis infarctiontype, infarct size, number of infarction, admission blood glucose, urine protein,whether application of anticoagulant, thrombolytic agent14risk factors, the singlefactor analysis and statistical significance for the infarction area (P=0.00), systolicblood pressure (P=0.037), anticoagulant condition (0.041), infarction volume(P=0.002). After multivariate Logistic regression analysis, a significant number ofinfarct area and infarct.Conclusion：1.clincal manifestation：HT patients showed a large number of hemiplegicpatients. Higher rates of occurrence of HT within15days after cerebral infarction.The proportion of patients with hemorrhage clinical manifestation of symptomsaggravated as the higher consciousness, the poor prognosis.2.Imaging: The infarct border small pieces of hemorrhage accounts forthe largest proportion. Infarction lesions of multiple infarction occurred moreoften than the single infarction and hemorrhagic transformation.3.Risk factor: The occurrence of HT, is the result of interaction of multiplefactors. Single factor analysis of statistical significance for the infarction area(P=0.00), systolic blood pressure (P=0.037), anticoagulant condition (0.041),infarction volume (P=0.002). Logistic multivariate regression analysis, a significantnumber of infarct area and infarct.4. Hemorrhagic cerebral infarction clinically after transformation does not necessarily is a sign of deterioration in patients, a considerable part of the conditionand the prognosis may be better than pure cerebral infarction patients. |
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