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Hyperintense acute reperfusion marker on FLAIR is not associated with early haemorrhagic transformation in the elderly

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Abstract

Objectives

The hyperintense acute reperfusion marker (HARM) has been described as a predictor for haemorrhagic transformation (HT) in acute ischaemic stroke. We hypothesised that this phenomenon is not present in the elderly.

Methods

It was possible to assess 47/84 consecutive patients aged 80 and over with diagnosed ischaemic stroke or transient ischaemic attack (TIA). MRI was performed within 24 h of onset of symptoms with follow-up MRI within a further 48 h.

Results

Of 47 included patients, 19 showed HARM; it was only seen on follow-up examination. Ten of the 47 patients underwent thrombolysis with recombinant tissue plasminogen activator (rt-PA); 4 of them showed HARM, and 1 of those showed HT. HARM was found in three out of eight patients with haemorrhagic transformation on baseline and/or follow-up MRI. We did not observe an association between HARM and early HT either in the whole group or in the patients who received thrombolysis.

Conclusion

HARM was not associated with HT in the elderly after ischaemic stroke, independent of treatment. While it may indicate dysfunction of the blood-brain barrier (BBB), it does not necessarily amount to HT.

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Acknowledgements

The project has received funding from the Federal Ministry of Education and Research via the grant Center for Stroke Research Berlin (01 EO 0801).

Disclosures

PD Dr. Fiebach reports receiving consulting, lecture and advisory board fees from BMS, Perceptive, Bioclinica, Boehringer Ingelheim, Lundbeck, Paion und Forrest.

Dr. Jungehülsing reports lecture and consulting fees from Boehringer Ingelheim, BMS, Sanofi and Genzyme, and was granted a fund by UCB.

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Authors and Affiliations

  1. Department of Neurology, Center for Stroke Research Berlin–CSB, Charité, Universitätsmedizin Berlin, Berlin, Germany

    Michal Rozanski, Martin Ebinger, Wolf U. Schmidt, Benjamin Hotter, Sandra Pittl, Peter U. Heuschmann, Jan G. Jungehuelsing & Jochen B. Fiebach

  2. Department of Neurology, Charite Campus Mitte, Intensive Care Unit 106i, Charitéplatz 1, 10117, Berlin, Germany

    Michal Rozanski

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  1. Michal Rozanski
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  2. Martin Ebinger
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Correspondence to Michal Rozanski.

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Rozanski, M., Ebinger, M., Schmidt, W.U. et al. Hyperintense acute reperfusion marker on FLAIR is not associated with early haemorrhagic transformation in the elderly. Eur Radiol 20, 2990–2996 (2010). https://doi.org/10.1007/s00330-010-1881-9

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  • DOI: https://doi.org/10.1007/s00330-010-1881-9

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