Remote Cerebral Bleeding After Thrombolysis

Pathophysiological Mechanisms

Local hemorrhage reflects reperfusion of necrotic tissue, with risk factors including acute large-vessel occlusion, CT hyperdense artery sign, atrial fibrillation, and elevated blood glucose, according to the American Heart Association, factors notably absent in remote hemorrhage 1
Greater baseline stroke severity predicts local but not remote hemorrhage, with a study published by the American Stroke Association showing that NIHSS >20 predicts local hemorrhage 1
Extensive early CT changes indicating large ischemic volume increase local hemorrhage risk, as reported by the Stroke journal 1