ABSTRACT
Interference between vascular walls that have been weakened by ischemic alterations and thrombolytic agents with proteolytic activity is probably the main cause of hemorrhagic complications following acute fibrinolysis in stroke. Hemorrhages are understood as leakage of cellular blood elements in infarcted tissue or as rupture of cerebral arteries. Previous experimental work exaggerated the importance of the cerebral microvasculature vessel wall in generating petechial bleedings leading to confluent hemorrhagic transformation as well as intracerebral hemorrhages. This chapter summarizes the changes in vessel walls following thrombosis and the possible implications for thrombolysis in acute stroke. We shall focus on microvascular changes.
