ECASS-II hemorrhage grades for post-procedure imaging evaluation. The scale was developed to assess hemorrhage related to intravenous thrombolysis, but has broader applicability
| ECASS-II hemorrhage grade* | Imaging criteria |
| Hemorrhagic infarction type 1 (HI1) | Small punctate petechial change around margins of infarct bed |
| Hemorrhagic infarction type 2 (HI2) | Confluent petechial within the infarct bed, but no mass effect |
| Parenchymal hematoma type 1 (PH1) | Hematoma (homogenous hyperdensity) ≤30% of infarct bed, mild mass effect |
| Parenchymal hematoma type 2 (PH2) | Hematoma (homogenous hyperdensity) >30% of infarct with significant mass effect, or hemorrhage beyond the infarct borders |
*Symptomatic intracranial hemorrhage requires >4 point increase in the National Institutes of Health Stroke Scale score from baseline in the first 7 days after treatment, in addition to radiological findings. Grading is performed based on post-treatment CT imaging and clinical examination, and predicts 90 day functional outcome (modified Rankin Scale grade).49 50
ECASS-II, European Cooperative Acute Stroke Study II.