Breaking down barriers to identify hemorrhagic transformation in ischemic stroke

Hemorrhagic transformation (HT) is a major complication in ischemic stroke, associated with increased morbidity and mortality. Identifying ischemic stroke patients at risk of HT could have substantial clinical implications, especially in the setting of thrombolytic therapy. Acute stroke patients at very high risk for HT could foreseeably have alternative treatment, such as a modified dose of thrombolytic agent or coadministration of a second agent able to reduce HT risk. In this issue of Neurology ®, Kazmierski et al.1 sought to predict clinical deterioration due to HT in ischemic stroke by measurements of proteins in blood. A total of 458 stroke patients were enrolled in their study, 85 of whom experienced clinical deterioration, and 33 of whom had HT. Stroke patients who developed HT had increased fasting glucose and decreased platelet count compared to those …