Intracranial hemorrhage following thrombolytic use for stroke caused by infective endocarditis.
OBJECTIVE
Stroke is one of the most common neurological manifestations of infective endocarditis. The use of intravenous tissue plasminogen activator (t-PA) in the management of acute ischemic stroke is the accepted standard of practice. Current guidelines for intravenous (IV) t-PA therapy in acute ischemic stroke do not exclude patients with infective endocarditis. We present three patients who received IV t-PA for acute ischemic stroke in the setting of infective endocarditis and developed multifocal intracranial hemorrhage as a complication.


CONCLUSIONS
Infective endocarditis related strokes are associated with a higher risk of hemorrhagic complications and our experience suggests that IV t-PA use may potentiate that risk.
Bhuva
Parita
P
Department of Neurology, Baylor College of Medicine, 6550 Fannin, Suite 1801, Houston, TX 77030, USA.
Kuo
Sheng-Han
SH
Claude Hemphill
J
J
Lopez
George A
GA
D000368:Aged; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D003354:Corynebacterium Infections / Q000150:complications*; D004697:Endocarditis, Bacterial / Q000150:complications*; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous; D020300:Intracranial Hemorrhages / Q000139:chemically induced* / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D013290:Streptococcal Infections / Q000150:complications*; D013345:Subarachnoid Hemorrhage / Q000139:chemically induced / Q000175:diagnosis; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000009:adverse effects* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D034363:Viridans Streptococci
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
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