Cerebral amyloid angiopathy related hemorrhage after stroke thrombolysis: case report and literature review.
Cerebral amyloid angiopathy (CAA) predisposes to symptomatic intracerebral hemorrhage (sICH) after combined thrombolytic and anticoagulant treatment of acute myocardial infarction. However, the role of CAA in stroke thrombolysis has not been established. Here, we describe a confirmed case of CAA-related hemorrhage in a patient receiving thrombolysis for acute ischemic stroke. On autopsy, immunohistochemistry revealed amyloid-β positive staining in thickened cortical and meningeal arteries at sites of hemorrhage. Further research is urgently needed to determine the hemorrhage risk related to CAA in stroke thrombolysis and develop better diagnostic tools to identify CAA in the emergency room.
Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland; Research Program of Molecular Neurology, Research Programs Unit, University of Helsinki, Helsinki, Finland; Department of Clinical Neurosciences, University of Helsinki, Helsinki, Finland.
Olli S
OS
Mattila
Tiina
T
Sairanen
Elina
E
Laakso
Anders
A
Paetau
Maarit
M
Tanskanen
Perttu J
PJ
Lindsberg
D000368:Aged; D002545:Brain Ischemia / Q000150:complications* / Q000188:drug therapy; D016657:Cerebral Amyloid Angiopathy / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D020521:Stroke / Q000150:complications* / Q000188:drug therapy; D015912:Thrombolytic Therapy / Q000009:adverse effects*
cerebral amyloid angiopathy; intracerebral hemorrhage; ischemic stroke; subarachnoid hemorrhage; thrombolysis