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 brain performed within 1 hour of hemiplegia onset at 9.00am

Modality: CT

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

CT performed at 6.00pm after tPA injection

Modality: CT

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: 21st Jan 2016
Inclusion in quiz mode: Included

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