Hemorrhagic Transformation of Ischemic Stroke: Mechanisms, Perioperative Risk Assessment and Clinical Management

Brief Overview of Theme and Scope

Hemorrhagic transformation is a devastating complication of acute ischemic stroke, with heightened clinical relevance in the era of reperfusion therapies including intravenous thrombolysis and endovascular thrombectomy. Its onset is tightly linked to procedural factors, perioperative care, and patient selection, and it remains a leading cause of poor prognosis and mortality in stroke patients undergoing surgical or endovascular intervention.

This Special Issue will focus on recent advances in the understanding, prevention, and management of hemorrhagic transformation in ischemic stroke, with a specific focus on operative and interventional perspectives aligned with the scope of the journal. We invite original research articles, systematic reviews, meta-analyses, and clinical observational studies addressing topics including, but not limited to:

- Pathophysiological mechanisms underlying procedure-related hemorrhagic transformation
- Pre-procedural risk prediction models and imaging biomarkers for patient selection
- Influence of endovascular technique, thrombolytic regimen, and perioperative management on bleeding risk
- Early recognition and grading of hemorrhagic transformation in the post-procedural setting
- Medical and neurosurgical management strategies for symptomatic intracranial hemorrhage
- Novel therapeutic approaches to reduce hemorrhagic risk and improve functional outcomes

The issue aims to bring together clinical and translational evidence from neurosurgeons, neurointerventional specialists, and stroke clinicians to guide evidence-based practice in this high-stakes field.