Extraparenchymal Bleeding Predicts an Unfavorable Outcome in Patients With Hemorrhagic Transformation

To the Editor: We read with interest the recent article by Fiorelli et al.1 The authors confirmed the reliability of hemorrhagic transformation (HT) as a diagnosis which, as we have found, could be made by either a neuroradiologist or a trained neurologist.2 However, of greater clinical relevance was the fact that they found that only severe HT (parenchymal hematoma 2 [PH2] in ECASS I1 ) was associated with an unfavorable outcome. As shown in the Table⇓, the same result emerged from the Multicentre Acute Stroke Trial–Italy (MAST-I) analysis.3 We have found that severe HT is very often associated with intraventricular or subarachnoid …