Definition of Hemorrhagic Conversion in Occupational Therapy
An ischemic infarct converting into a hemorrhagic lesion.
Prevalence and Cause
- Occurs in 10% of patients.
- More common in large infarcts.
- Ranges from minor bleeding to major hemorrhage.
- Thrombi can migrate, lyse, and re-perfuse into an ischemic area, leading to small hemorrhages because of poor integrity in the damaged capillaries and small blood vessels. Damaged areas then combine and form a hemorrhage.
- In other words, a few hours after an area of brain tissue has died, it loses its ability to retain blood inside of the arteries, increasing the risk that a large hemorrhage will occur if blood flow were to be returned.
Prevention
- In patients with large infracts, anticoagulation therapy is not used due to the risk of hemorrhagic conversion.
- Approximately 6% of all stroke cases treated with intravenous tPA experience a hemorrhagic conversion, hence the current practice of administration within the window after the onset of symptoms.cc
Occupational Therapy Intervention
- Educate patients and family about stroke symptoms and activating EMS due to the benefits of anticoagulants (tPA) within the golden hour/window.
- Monitor patients during treatments for symptoms of neurological changes that may be due to hemorrhagic conversion.
