Open AccessTenecteplase-induced nonaneurysmal subarachnoid hemorrhage in a patient with acute ischemic stroke: A case report and literature review
Author(s) -
Biplab Das,
Anshu Mahajan,
Gaurav Goel,
Arun Garg
Publication year - 2020
Publication title -
asian journal of neurosurgery
Language(s) - English
Resource type - Journals
ISSN - 2248-9614
DOI - 10.4103/ajns.ajns_131_20
Subject(s) - medicine , tenecteplase , thrombolysis , subarachnoid hemorrhage , complication , stroke (engine) , fibrinolytic agent , cerebral angiography , tissue plasminogen activator , angiography , radiology , surgery , anesthesia , cardiology , mechanical engineering , myocardial infarction , engineering
Recently, tenecteplase (TNK) has been used for intravenous thrombolysis in acute ischemic stroke (AIS). Although spontaneous subarachnoid hemorrhage (SAH) following thrombolysis with tissue plasminogen activator has been reported, there is a lack of literature regarding TNK-induced nonaneurysmal spontaneous SAH. Our index case received intravenous TNK within an hour of symptom onset of AIS. Following deterioration of sensorium, repeat noncontrast computed tomography was performed, which showed diffuse SAH. Cerebral angiography did not reveal any aneurysm. Nonaneurysmal SAH can be a complication of TNK thrombolysis, which is not reported in literature. Knowledge of this possible adverse reaction is critical for appropriate counseling and management.