Spinal epidural hematoma complicating thrombolytic therapy with tissue plasminogen activator--a case report.
Patients who receive thrombolytic therapy are at risk of central nervous system (CNS) hemorrhage, and this diagnosis must be sought in any patient who develops neurologic complaints after thrombolysis and anticoagulation. Early imaging and neurosurgical consultation are essential to improve outcome after hemorrhage occurs. We describe a patient who developed spinal epidural hematoma (SEH) after thrombolysis and anticoagulation for acute myocardial infarction. Delay in diagnosis and management may have contributed to a poor outcome. The literature on SEH is reviewed, and approaches to improve the prognosis of patients suffering CNS hemorrhage after thrombolysis are discussed.
Clark
Mark A
MA
Department of Emergency Medicine, St Luke's - Roosevelt Hospital Center, New York, New York, USA.
Paradis
Norman A
NA
D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006407:Hematoma, Epidural, Cranial / Q000139:chemically induced* / Q000601:surgery; D006801:Humans; D007796:Laminectomy; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy; D013116:Spinal Cord / Q000473:pathology* / Q000601:surgery; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000009:adverse effects*
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator