Catastrophic Intracranial Hemorrhages after IV tPA in a Patient with Insidious Onset of Fever and Back Pain

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
Steven TverskyJeffrey M Katz

Abstract

Infective endocarditis is associated with unstable infective vegetations, which have a propensity to embolize and cause embolic events, such as stroke. Many cases present with an embolic event as the first sign of infective endocarditis. We present a patient who had a history of recent and persistent fever, an acute ischemic stroke treated with intravenous tissue plasminogen activator (IV tPA), and severe, multifocal intracerebral hemorrhage as a complication of tPA treatment. Suspected infective endocarditis in a stroke patient should most likely be considered a contraindication to IV tPA.

References

Feb 3, 2012·Neurosurgical Focus·Haitham DababnehMichael F Waters
Aug 15, 2013·Stroke; a Journal of Cerebral Circulation·Ganesh AsaithambiAdnan I Qureshi
Feb 18, 2014·Internal Medicine Journal·W J BrownleeP A Barber
Feb 18, 2014·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Hadi D ToegRoy G Masters

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Citations

Dec 23, 2017·Rinshō shinkeigaku = Clinical neurology·Kaoru NakanishiTeruyuki Hirano
Dec 2, 2020·Progress in Lipid Research·Hiroshi Ueda

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