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Case report Cerebral hemorrhage after systemic fibrinolysis in a patient with severe carotid artery stenosis
Author(s) -
Stapf C.,
Mohr J. P.,
ThéallierJankó A.
Publication year - 1999
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1999.tb01061.x
Subject(s) - medicine , intracerebral hemorrhage , fibrinolysis , stenosis , stroke (engine) , amaurosis fugax , cardiology , middle cerebral artery , transcranial doppler , intraparenchymal hemorrhage , subarachnoid hemorrhage , ischemia , mechanical engineering , engineering
Despite the beneficial effect of systemic fibrinolysis in treatment within 3 hours from ischemic stroke onset, the unpredicted occurrence of intracerebral hemorrhage remains a risk from such therapy. Few data exist defining patients at risk for this outcome. We report clinical and neuropathological data on a patient fulfilling NINDS rt‐PA study and ECASS‐2 inclusion criteria with an acute stroke due to high‐grade carotid artery stenosis and preceded by amaurosis fugax. He died from an intracerebral hemorrhage after systemic fibrinolysis. The fatal outcome adds support to recommendations that rapid Doppler‐sonographic evaluation of the extra‐ and intracranial vascular status be undertaken before systemic rt‐PA is implemented in acute ischemic stroke.