Early identification and integrated nursing management of post-thrombolysis hemorrhagic transformation in acute ischemic stroke: a comprehensive review

Acute ischemic stroke (AIS) is a leading cause of high global disability and mortality rates. Intravenous thrombolysis (IVT) is a key therapeutic intervention for restoring blood flow and salvaging the ischemic penumbra. However, it can be complicated by severe hemorrhagic transformation (HT). Symptomatic intracranial hemorrhagic transformation significantly increases the risk of death and disability in patients and is a major limiting factor affecting the benefit of thrombolysis. This article aims to comprehensively analyze relevant literature and systematically explore early identification methods for hemorrhagic transformation following thrombolysis in AIS patients, as well as scientific and systematic nursing management strategies. By reviewing key risk factors, pathological mechanisms, and evidence-based interventions, it seeks to provide a reference basis for the clinical early identification of patients at high risk for HT, the implementation of targeted nursing interventions to mitigate the harm of HT, and the improvement of patient outcomes.