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Multiple Cerebral Microbleeds in Hyperacute Ischemic Stroke: Impact on Prevalence and Severity of Early Hemorrhagic Transformation After Thrombolytic Treatment

Ho Sung Kim1, Deok Hee Lee1, Chang Woo Ryu1, Jeong Hyun Lee1, Choong Gon Choi1, Sang Joon Kim1 and Dae Chul Suh1

1 All authors: Department of Radiology, Neuroradiology, and Research Institute of Radiology, Asan Medical Center, 388-1 Poongnap-dong, Songpa-gu, Seoul, South Korea.


Figure 1
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  		Fig. 1A —Classification of microbleeds by number. Grade 1, 0 microbleeds. in 53-year-old man.

 

Figure 2
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  		Fig. 1B —Classification of microbleeds by number. Grade 2, 1-2 microbleeds in 62-year-old woman. Normal finding of bilateral low signal intensity (arrows) is present in globus pallidus.

 

Figure 3
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  		Fig. 1C —Classification of microbleeds by number. Grade 3, 3-10 microbleeds in 59-year-old woman.

 

Figure 4
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  		Fig. 1D —Classification of microbleeds by number. Grade 4, more than 10 microbleeds in 67-year-old man.

 

Figure 5
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  		Fig. 2A —82-year-old woman with sudden altered mentality 4 hr before examination. T2*-weighted MR images of two different locations (A, level of frontal horn of lateral ventricle; B, level of anterior commissure) obtained before thrombolysis show grade 4 microbleeds.

 

Figure 6
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  		Fig. 2B —82-year-old woman with sudden altered mentality 4 hr before examination. T2*-weighted MR images of two different locations (A, level of frontal horn of lateral ventricle; B, level of anterior commissure) obtained before thrombolysis show grade 4 microbleeds.

 

Figure 7
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  		Fig. 2C —82-year-old woman with sudden altered mentality 4 hr before examination. Follow-up T2*-weighted MR image (C) and diffusion-weighted image (D) 2 days after intraarterial thrombolytic treatment show no evidence of hemorrhagic transformation in final infarcted area.

 

Figure 8
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  		Fig. 2D —82-year-old woman with sudden altered mentality 4 hr before examination. Follow-up T2*-weighted MR image (C) and diffusion-weighted image (D) 2 days after intraarterial thrombolytic treatment show no evidence of hemorrhagic transformation in final infarcted area.

 

Figure 9
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  		Fig. 3A —61-year-old man with altered mentality 3 hr before examination. Initial T2*-weighted MR images of two different locations (A, level of frontal operculum; B, level of temporal lobe just below A) show grade 4 microbleeds.

 

Figure 10
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  		Fig. 3B —61-year-old man with altered mentality 3 hr before examination. Initial T2*-weighted MR images of two different locations (A, level of frontal operculum; B, level of temporal lobe just below A) show grade 4 microbleeds.

 

Figure 11
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  		Fig. 3C —61-year-old man with altered mentality 3 hr before examination. Follow-up T2*-weighted MR image 1 day after intraarterial thrombolytic treatment shows hemorrhagic transformation in right anterior cerebral artery territory.

 

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