title: Intracranial hemorrhage following thrombolytic use for stroke caused by infective endocarditis.
abstract: 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.
authors.affiliation: Department of Neurology, Baylor College of Medicine, 6550 Fannin, Suite 1801, Houston, TX 77030, USA.
authors.forename: Parita
authors.initials: P
authors.lastname: Bhuva
authors.forename: Sheng-Han
authors.initials: SH
authors.lastname: Kuo
authors.forename: J
authors.initials: J
authors.lastname: Claude Hemphill
authors.forename: George A
authors.initials: GA
authors.lastname: Lopez
mesh_terms: 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
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
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