title: Medical Decision Making: Hyposphagma Prior to Intravenous Tissue Plasminogen Activator in Acute Ischemic Stroke.
abstract: The decision to administer intravenous tissue plasminogen activator (IV tPA) is based on standard exclusion and inclusion criteria, which include laboratories, imaging, and time of last known well. When patients present with a clinical scenario that is not addressed in these standards, the decision to administer IV tPA is more complex. We present a case of a patient with an acute stroke syndrome that also included acute subconjunctival hemorrhage (i.e., hyposphagma). We provide the medical decision making that occurred prior to the administration. Ultimately, the finding of hyposphagma should not disqualify eligible patients from receiving IV tPA.
authors: Department of Neurology, University of Chicago, Chicago, Illinois. Electronic address: neweyc@health.missouri.edu.
authors: Christopher R
authors: CR
authors: Newey
authors: Department of Neurology, Emory University, Atlanta, Georgia.
authors: Wilson
authors: W
authors: Cueva
authors: Department of Neurology, University of Chicago, Chicago, Illinois.
authors: Anantha
authors: A
authors: Vellipuram
authors: Brain and Spine Institute, Southern Illinois Healthcare, Carbondale, Illinois.
authors: Alejandro
authors: A
authors: Hornik
mesh_terms: D061605:Administration, Intravenous; D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002533:Cerebral Angiography / Q000379:methods; D000072226:Computed Tomography Angiography; D003229:Conjunctival Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D038524:Diffusion Magnetic Resonance Imaging; D005130:Eye Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator
keywords: Tissue plasminogen activator; acute ischemic stroke; hyposphagma; subconjunctival hemorrhage