Early Neurological Deterioration during Alteplase Infusion for Acute Ischemic Stroke

An Uncommon Complication of Intravenous Thrombolysis

Apostolos Safouris, Odysseas Kargiotis, Georgios Magoufis, Aristeidis H. Katsanos, Eleftherios Stamboulis, Georgios Tsivgoulis

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction:Recognizing new-Territory ischemic stroke as an uncommon complication of intravenous thrombolysis is very important as it can lead to neurological deterioration during tissue-plasminogen-Activator infusion.Case Report:We report a case of an 80-year-old patient that has been treated with intravenous thrombolysis for right middle cerebral artery acute ischemic stroke. During infusion he had an abrupt neurological deterioration that proved to be a distal embolization of an asymptomatic non-occluding tip-of-The-basilar thrombus to the territory of left posterior cerebral artery that has been missed by the treating neurologist and radiologist in the pretreatment computed tomography angiography. In the thrombectomy that followed, only the right carotid artery has been catheterized and only the right middle cerebral artery was successfully recanalized, leaving the left posterior cerebral artery occlusion untreated.Conclusions:This case highlights that the use of thrombectomy in clinical practice provides an effective therapeutic option for large vessel occlusion in this setting. However, high clinical suspicion for this rare complication is mandatory to proceed to correct diagnosis and treatment.

Original languageEnglish (US)
Pages (from-to)90-91
Number of pages2
JournalNeurologist
Volume22
Issue number3
DOIs
StatePublished - Jan 1 2017

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Posterior Cerebral Artery
Thrombectomy
Middle Cerebral Artery
Tissue Plasminogen Activator
Stroke
Hong Kong
Carotid Arteries
Thrombosis
Therapeutics
Radiologists
Neurologists
Computed Tomography Angiography

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

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Early Neurological Deterioration during Alteplase Infusion for Acute Ischemic Stroke : An Uncommon Complication of Intravenous Thrombolysis. / Safouris, Apostolos; Kargiotis, Odysseas; Magoufis, Georgios; Katsanos, Aristeidis H.; Stamboulis, Eleftherios; Tsivgoulis, Georgios.

In: Neurologist, Vol. 22, No. 3, 01.01.2017, p. 90-91.

Research output: Contribution to journalArticle

Safouris, Apostolos ; Kargiotis, Odysseas ; Magoufis, Georgios ; Katsanos, Aristeidis H. ; Stamboulis, Eleftherios ; Tsivgoulis, Georgios. / Early Neurological Deterioration during Alteplase Infusion for Acute Ischemic Stroke : An Uncommon Complication of Intravenous Thrombolysis. In: Neurologist. 2017 ; Vol. 22, No. 3. pp. 90-91.
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