The lacunar infarction with persistent trigeminal artery and delayed symptomatic hemorrhagic transformation: a case report

Hemorrhagic transformation (HT) is usually seen in patients with massive cerebral infarction, or patients undergoing thrombolysis or mechanical thrombectomy, which usually occurs in the acute phase of ischemic stroke. We present a case of a 61-year-old male patient with acute lacunar infarction in left posterior limb of the internal capsule with right persistent trigeminal artery (PTA). On the 20th day after the disease onset, the patient developed cerebral hemorrhage at the corresponding site. In addition. The susceptibility weighted imaging (SWI) showed multiple microbleeds in the brain. PTA is a risk factor for exacerbation of acute ischemic stroke, which may lead to secondary cerebral hemorrhage through some potential mechanisms.