Cerebral haemorrhage post tPA thrombolysis

Case contributed by Dr Chris O'Donnell

Presentation

Acute right hemiplegia treated within 3 hours by IV tPA. Marked worsening of hemiplegia and reduced conscious state about 6 hours later.

Patient Data

Age: 70 years
Gender: Male
CT

CT brain performed within 1 hour of hemiplegia onset at 9.00am

Hyperdense right MCA without loss of grey white differentiation. No hemorrhage could be seen.

CT

CT performed at 6.00pm after tPA injection

Large right cerebral hematoma with intraventricular extension. Hyperdense R MCA is no longer present.

Case Discussion

Although tPA (tissue plasminogen activator) thrombolysis can lead to substantial clinical improvement in MCA occlusion there is always a risk of haemorrhage

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Case information

rID: 19776
Case created: 11th Oct 2012
Last edited: 29th Jun 2017
Inclusion in quiz mode: Included

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