Article Text

Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
Haemorrhagic transformation of a recent silent cerebral infarct during thrombolytic stroke treatment
  1. Karsten Bruins Slot,
  2. Eivind Berge,
  3. Joanna Wardlaw
  1. Ullevaal University Hospital, Department of Internal Medicine, Kirkeveien 166, Oslo 0407, Norway
  1. karsten.bruins.slot{at}


We present a patient in her 60s who was admitted with a sudden loss of power in her right arm and leg, right sided facial weakness, and difficulties with speaking. An acute ischaemic stroke in the left hemisphere was diagnosed and the patient received intravenous thrombolytic treatment. Treatment was stopped halfway as a cerebral haemorrhage was suspected. A small haemorrhage in the right frontal cortex was thereafter identified on computed tomography (CT) and magnetic resonance imaging scans. Re-examination of the CT scan taken before the start of thrombolytic treatment revealed a recent silent infarct with cortical petechial haemorrhage at this site. A month later the patient still suffered from a partial paralysis in her right arm and leg, but could now walk without help; she did not have any lasting symptoms of the haemorrhage. Our case illustrates that a recent silent infarct can be a cause of a haemorrhage at an unexpected site during thrombolytic treatment.

  • 382
  • 232
  • 488

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Competing interests: none.

  • Patient consent: Patient/guardian consent was obtained for publication