Table 1

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.