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KMID : 1201420170100020107
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Journal of Neurocritical Care
2017 Volume.10 No. 2 p.107 ~ p.111
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Aneurysmal Subarachnoid Hemorrhage Following Intravenous Thrombolysis in Acute Ischemic Stroke
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Kim Hyo-Jae
Kang Dong-Wha
Kwon Sun-U.
Kim Jong-S.
Jeon Sang-Beom
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Abstract
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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.
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KEYWORD
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Cerebral infarction, Thrombolytic therapy, Cerebral aneurysm
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