Hemorrhagic Transformation in Ischemic Stroke and the Role of Inflammation

Hemorrhagic transformation (HT) is a common complication in patients with acute ischemic stroke. It occurs when peripheral blood extravasates across a disrupted blood brain barrier (BBB) into the brain following ischemic stroke. Preventing HT is important as it worsens stroke outcome and increases m...

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Published inFrontiers in neurology Vol. 12; p. 661955
Main Authors Spronk, Elena, Sykes, Gina, Falcione, Sarina, Munsterman, Danielle, Joy, Twinkle, Kamtchum-Tatuene, Joseph, Jickling, Glen C.
Format Journal Article
LanguageEnglish
Published Frontiers Media S.A 14.05.2021
Subjects
aging
diabetes
hemorrhagic transformation
hypertension
inflammation
ischemic stroke
Neurology
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ISSN1664-2295
1664-2295
DOI10.3389/fneur.2021.661955

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Summary:Hemorrhagic transformation (HT) is a common complication in patients with acute ischemic stroke. It occurs when peripheral blood extravasates across a disrupted blood brain barrier (BBB) into the brain following ischemic stroke. Preventing HT is important as it worsens stroke outcome and increases mortality. Factors associated with increased risk of HT include stroke severity, reperfusion therapy (thrombolysis and thrombectomy), hypertension, hyperglycemia, and age. Inflammation and the immune system are important contributors to BBB disruption and HT and are associated with many of the risk factors for HT. In this review, we present the relationship of inflammation and immune activation to HT in the context of reperfusion therapy, hypertension, hyperglycemia, and age. Differences in inflammatory pathways relating to HT are discussed. The role of inflammation to stratify the risk of HT and therapies targeting the immune system to reduce the risk of HT are presented.
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Edited by: Nishant K. Mishra, University of California, Los Angeles, United States
Reviewed by: Georgios Tsivgoulis, National and Kapodistrian University of Athens, Greece; Hansen Chen, Stanford University, United States
This article was submitted to Stroke, a section of the journal Frontiers in Neurology
ISSN:1664-2295
1664-2295
DOI:10.3389/fneur.2021.661955