title: Use of Recombinant Factor VIIa in Symptomatic Intracerebral Hemorrhage Following Intravenous Thrombolysis.
abstract: Symptomatic intracerebral hemorrhage (sICH) occurs in up to 7% of stroke patients treated with thrombolytic therapy. There are limited data on the effectiveness of the reversal agents used for intravenous tissue plasminogen activator related intracranial bleeds. We report a patient with sICH following intravenous thrombolysis whose intracerebral hemorrhage continued to expand despite treatment with platelets and cryoprecipitate, needing recombinant factor VIIa use for stabilization before surgical evacuation. Factor VIIa along with routine reversal agents following intravenous thrombolysis related sICH may further enhance clot stability and reduce the risk of hematoma expansion. It could be a bridge to definitive surgical management in those patients.
authors.affiliation: Department of Neurology, Columbia University Medical Center , New York, NY, USA.
authors.forename: Shadi
authors.initials: S
authors.lastname: Yaghi
authors.affiliation: Department of Neurology, Columbia University Medical Center , New York, NY, USA.
authors.forename: Aya
authors.initials: A
authors.lastname: Haggiagi
authors.affiliation: Department of Neurology, Columbia University Medical Center , New York, NY, USA.
authors.forename: Ayesha
authors.initials: A
authors.lastname: Sherzai
authors.affiliation: Department of Neurology, Columbia University Medical Center , New York, NY, USA.
authors.forename: Randolph S
authors.initials: RS
authors.lastname: Marshall
authors.affiliation: Department of Neurology, Columbia University Medical Center , New York, NY, USA.
authors.forename: Sachin
authors.initials: S
authors.lastname: Agarwal
keywords: Intracerebral hemorrhage; expansion; factor VIIa; ischemic stroke; outcome; thrombolysis