What CT findings would suggest hemorrhagic transformation after reperfusion therapy?

What CT findings would suggest hemorrhagic transformation after reperfusion therapy?

• A. New or enlarging hyperdense areas consistent with intracranial hemorrhage on follow-up CT
• B. New non-enhancing lesions
• C. No hemorrhage changes
• D. Only seen on MRI

Answer: (D)

Hemorrhagic transformation after reperfusion therapy shows up on CT as new or enlarging hyperdense areas within the brain, representing acute blood. On follow-up non-contrast CT, these hyperdensities indicate that bleeding has occurred into the infarcted tissue. The presence of new or expanding bright foci within the ischemic region is the clearest CT sign that hemorrhage has developed. This matters because acute blood on CT is readily visible and helps guide management, since continued anticoagulation or further reperfusion strategies may be contraindicated in the presence of hemorrhage. While MRI can also detect hemorrhage (often with greater sensitivity in some cases), CT is a primary tool for identifying hemorrhagic transformation acutely. The other scenarios described (no hemorrhage, new non-enhancing lesions, or findings seen only on MRI) do not reflect acute hemorrhagic transformation on CT.

Hemorrhagic transformation after reperfusion therapy shows up on CT as new or enlarging hyperdense areas within the brain, representing acute blood. On follow-up non-contrast CT, these hyperdensities indicate that bleeding has occurred into the infarcted tissue. The presence of new or expanding bright foci within the ischemic region is the clearest CT sign that hemorrhage has developed.

This matters because acute blood on CT is readily visible and helps guide management, since continued anticoagulation or further reperfusion strategies may be contraindicated in the presence of hemorrhage. While MRI can also detect hemorrhage (often with greater sensitivity in some cases), CT is a primary tool for identifying hemorrhagic transformation acutely. The other scenarios described (no hemorrhage, new non-enhancing lesions, or findings seen only on MRI) do not reflect acute hemorrhagic transformation on CT.