Neither asymptomatic nor inevitable: intracerebral hemorrhage after reperfusion treatment.

Endovascular treatment (EVT) has brought a radical change to acute stroke care with tremendous improvement of clinical outcome of patients with large vessel occlusion (LVO). However, EVT also carries risks, the most feared being intracerebral hemorrhage (ICH) after treatment. The risk of secondary ICH after intravenous thrombolysis (IVT) has been attributed to the biological effect of thrombolytic drugs, but also to successful reperfusion in ischemic brain tissue (1). EVT usually does not involve thrombolytic drugs.