Symptomatic hemorrhage after alteplase therapy not due to silent ischemia.

Journal article

BACKGROUND: Stroke thrombolysis-related intracerebral hemorrhage may occur remotely from the anatomical site of ischemia. One postulated mechanism for this is simultaneous multiple embolization with hemorrhage into a "silent" area of ischemia. RESULTS: A patient suffered a disabling stroke affecting the right cerebral hemisphere. He was treated with intravenous alteplase and underwent extensive early imaging with multimodal MRI. Several hours after treatment he developed a brainstem hemorrhage despite having no evidence of ischemia on DWI MRI in the brainstem. CONCLUSION: Not all occurrences of remote ICH after stroke thrombolysis are secondary to multiple emboli with silent ischemia.

Authors: Hill, MD; Barber, P; Demchuk, A; Sevick, R; Frayne, R

• Journal: BMC neurology
• Volume: 1
• Issue: 1
• Pages: 1
• Publication date: 2001-12-01
• DOI: 10.1186/1471-2377-1-1
• EISSN: 1471-2377
• ISSN: 1471-2377
• Language: English
• Keywords: Brain Ischemia; Diagnosis, Differential; Tomography, X-Ray Computed; Intracranial Hemorrhages; Humans; Muscle Weakness; Aged; Stroke; Fatal Outcome; Fibrinolytic Agents; Tissue Plasminogen Activator; Magnetic Resonance Imaging; Male