Aim: To determine the causes of intracranial hemorrhage (ICH) following endovascular thrombectomy (EVT) in patients with large vessel system (LVO). ICH is a cause of fatal birth defects and morbidity. This study was designed to evaluate the causes of ICH after successful mechanical thrombectomy (MT) in patients with acute ischemic stroke. Methods: This retrospective study included isolation of anterior circulation LVO with ASPECTS scores > 6, where symptoms were successfully treated with recanalization from 6 hours onwards. The study aimed to investigate the causes of intracranial hemorrhage occurring within 24 hours. Results: The study included 123 patients with a history of LVO ischemic stroke. ICH developed in 37 (30%) patients. Low ASPECT score (p<0.01), high 24-hour NIHS score (p<0.01), high passage rates (p<0.01), low lymphocyte count (p<0.01), high 3-month MRS score (p<0.01), presence of hyperlipidemia (p<0.05), low first-pass recanalization rate (p<0.01), presence of distal embolism (p<0.01), and growth rate of cardioembolic stroke etiology (p<0.01) were associated with the progression of ICH development. In a multivariate logistic regression model, cardioembolic etiology was found to be an independent predictor of ICH. Conclusion: A low ASPECT score, high 24-hour NIHS score, high pass counts, low lymphocyte counts, high 3-month MRS score, presence of hyperlipidemia, low first-pass recanalization rate, and presence of distal embolism indicated the progression of ICH. The etiology of cardioembolic stroke was an independent vision of ICH.
Memiş et al. (2026) studied this question.