Is asymptomatic hemorrhagic transformation really innocuous?

Abstract

# {#article-title-2} Writ e Click submissions this week reference the article by Dr. Park et al., “Is asymptomatic hemorrhagic transformation really innocuous?” and bring up the possibility of confounding factors in the analysis. Drs. Libman and Kwiatkowski ask that the authors reanalyze their data to adjust for lesion volume. The authors regret that they were not able to measure lesion volume in their study but point out that reports suggest clinical variables are better prognosticators of stroke outcome than radiologic variables. Drs. El-Zammar and Levine suggest the possibility of bias due to stroke etiology, thrombolysis administration, and the statistical handling of disability scores. The authors respond by explaining their statistical methodology but admit the possibility of residual bias despite their adjustments. All agree that analyzing prognostic factors in stroke outcome remains a challenging endeavor. Megan Alcauskas, MD, and Robert C. Griggs, MD Park et al.1 found that patients with asymptomatic hemorrhagic transformation of an infarct had worse functional outcome in 3 months compared to patients without hemorrhagic transformation. The concept of whether asymptomatic hemorrhagic transformation may exert subtle adverse effects that may …