Cerebral hemorrhage after systemic fibrinolysis in a patient with severe carotid artery stenosis.
Despite the beneficial effect of systemic fibrinolysis in treatment within 3 hours from ischemic stroke onset, the unpredicted occurrence of intracerebral hemorrhage remains a risk from such therapy. Few data exist defining patients at risk for this outcome. We report clinical and neuropathological data on a patient fulfilling NINDS rt-PA study and ECASS-2 inclusion criteria with an acute stroke due to high-grade carotid artery stenosis and preceded by amaurosis fugax. He died from an intracerebral hemorrhage after systemic fibrinolysis. The fatal outcome adds support to recommendations that rapid Doppler-sonographic evaluation of the extra- and intracranial vascular status be undertaken before systemic rt-PA is implemented in acute ischemic stroke.
Stapf
C
C
Stroke Unit/Neurologische Klinik, Berlin, Germany.
Mohr
J P
JP
Théallier-Jankó
A
A
Mast
H
H
D000328:Adult; D020757:Amaurosis Fugax / Q000209:etiology; D002545:Brain Ischemia / Q000517:prevention & control*; D016893:Carotid Stenosis / Q000150:complications*; D002543:Cerebral Hemorrhage / Q000139:chemically induced*; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D010960:Plasminogen Activators / Q000009:adverse effects*; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology*; D015912:Thrombolytic Therapy / Q000009:adverse effects*
D010960:Plasminogen Activators