Aneurysmal Subarachnoid Hemorrhage Following Intravenous Thrombolysis in Acute Ischemic Stroke
- Author:
Hyo Jae KIM
1
;
Dong Wha KANG
;
Sun U KWON
;
Jong S KIM
;
Sang Beom JEON
Author Information
- Publication Type:Case Report
- Keywords: Cerebral infarction; Thrombolytic therapy; Cerebral aneurysm
- MeSH: Aneurysm; Angiography; Aphasia; Blister; Blood Pressure; Brain; Cerebral Infarction; Cerebrum; Emergency Service, Hospital; Humans; Incidental Findings; Intracranial Aneurysm; Intracranial Hemorrhages; Middle Aged; Middle Cerebral Artery; Rupture; Stroke; Subarachnoid Hemorrhage; Thrombolytic Therapy; Tissue Plasminogen Activator
- From: Journal of Neurocritical Care 2017;10(2):107-111
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: An incidental finding of unruptured aneurysm, which is a contraindication to the recombinant tissue plasminogen activator (rtPA), is common in patients with acute ischemic strokes. However, reports describing the rupture of intracranial aneurysm following the administration of rtPA are extremely rare. CASE REPORT: A 51-year-old man presented to the emergency room with global aphasia. A computed tomography (CT) of the brain revealed no intracranial hemorrhage. Since global aphasia occurred in an hour, rtPA was administrated intravenously. A CT angiography was performed 2 hours after an infusion of rtPA, which despite the absence of neurological deterioration and blood pressure surge, revealed subarachnoid hemorrhage in the right cerebral hemisphere, in addition to a 3-mm saccular aneurysm with a bleb in the right middle cerebral artery. CONCLUSIONS: Aneurysmal subarachnoid hemorrhage can develop following the infusion of rtPA. Hence, unruptured aneurysm may not simply be an “incidental finding” in stroke patients receiving rtPA.
