title: Cardiovascular Instability Preceded by Orolingual Angioedema after Alteplase Treatment.
abstract: An 87-year-old man taking antihypertensive medications, including 10 mg enalapril, daily visited our hospital complaining of motor aphasia, dysarthria, and right hemiparesis. Magnetic resonance imaging revealed an ischemic lesion in the left frontal lobe including the insular cortex and severe stenosis of the left middle cerebral artery. After he received intravenous alteplase infusion, he developed orolingual angioedema followed by transient bradycardia with subsequent hypotension, resulting in the deterioration of his neurological signs and expansion of the ischemic lesion. Orolingual angioedema after intravenous alteplase infusion may follow cardiovascular instability and disease progression in stroke patients.
authors.affiliation: Department of Neurology, Tenri Hospital, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kageyama
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Okanoue
authors.forename: Rieko
authors.initials: R
authors.lastname: Takai
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Suenaga
mesh_terms: D000369:Aged, 80 and over; D000799:Angioedema / Q000139:chemically induced* / Q000473:pathology; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001039:Aphasia, Broca / Q000209:etiology; D002540:Cerebral Cortex / Q000473:pathology; D018450:Disease Progression; D004401:Dysarthria / Q000209:etiology; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005625:Frontal Lobe / Q000473:pathology; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D009055:Mouth / Q000473:pathology*; D010291:Paresis / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects*; D014059:Tongue / Q000473:pathology*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D000959:Antihypertensive Agents; D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator; D006854:Hydrocortisone