title: Systemic thrombolysis in ischemic stroke after recent oral surgery and management of oral cavity bleeding.
abstract: Thrombolysis with recombinant tissue plasminogen activator in the treatment of acute ischemic stroke carries a long list of contraindications. One of these is recent surgery, but the extent of complications after minor surgeries such as dental extraction or oral surgical procedures is unclear. Here, we report the management of 2 cases with accidental bleeding from the oral cavity during systemic thrombolysis in ischemic stroke because of recent unreported oral surgery. Bleeding at the operation site occurred early and was stopped by prompt discontinuation of the recombinant tissue plasminogen activator infusion and local compressive therapy. Patients and relatives may not be aware that surgical procedures within the oral cavity are regarded as minor surgery and should be explicitly asked during the evaluation of ischemic stroke within the period for thrombolysis.
authors.affiliation: Neurologische Klinik und Poliklinik, Technische Universität München, Munich, Germany. c.seifert@lrz.tu-muenchen.de
authors.forename: Christian L
authors.initials: CL
authors.lastname: Seifert
authors.forename: Till
authors.initials: T
authors.lastname: Sprenger
authors.forename: Thomas
authors.initials: T
authors.lastname: Mücke
authors.forename: Annette
authors.initials: A
authors.lastname: Foerschler
authors.forename: Holger
authors.initials: H
authors.lastname: Poppert
authors.forename: Bernhard
authors.initials: B
authors.lastname: Hemmer
authors.forename: Johann
authors.initials: J
authors.lastname: Sellner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000209:etiology*; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects*; D010959:Tissue Plasminogen Activator / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator