Fatal Intraperitoneal Bleeding after Intravenous Administration of Tissue Plasminogen Activator.
J Stroke Cerebrovasc Dis
; 24(7): e177-8, 2015 Jul.
Article
em En
| MEDLINE
| ID: mdl-25899160
ABSTRACT
We report a case of acute ischemic stroke, which developed fatal intraperitoneal bleeding after intravenous administration of alteplase. An 86-year-old woman developed acute infarction of the right middle cerebral artery during admission for chronic heart failure. Two days before the stroke, liver biopsy was performed; the result was benign. Although rivaroxaban was prescribed for atrial fibrillation, the rivaroxaban had been discontinued for liver biopsy until the time when she developed the stroke. A condition of recent biopsy required careful determination of eligibility of intravenous alteplase; however, we considered that the benefit of intravenous alteplase outweighed the hemorrhagic adverse effects. Alteplase (0.6 mg/kg) was started 2 hours after the stroke onset, however, no clinical improvement was obtained. One hour after the completion of alteplase, she suddenly developed a shock state. Emergent computed tomography disclosed massive intraperitoneal hemorrhage. She died 8 hours after the completion of alteplase. In the present case, mechanical thrombectomy without intravenous alteplase can be an alternative therapeutic option.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Terapia Trombolítica
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Ativador de Plasminogênio Tecidual
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Infarto da Artéria Cerebral Média
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Fibrinolíticos
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Hemorragia
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Risk_factors_studies
Limite:
Aged80
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Female
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Humans
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article