Intravenous thrombolysis in patient with acute ischemic stroke and brain aneurysm – case report
Keywords:
acute ischemic stroke, intracranial aneurysm, thrombolysis, tissue plasminogen activatorAbstract
Intracranial hemorrhage (ICH) is one of the most serious and undesirable complications in the specific treatment of acute ischemic stroke (AIS). Many of the contraindications for intravenous (IV) thrombolysis are to avoid the risk of subsequent ICH. Many factors influence the risk of bleeding during IV thrombolysis – time from symptoms onset, stroke severity, previous antiplatelet or anticoagulant treatment, coagulation status, blood pressure, brain aneurysms and brain vascular malformations.
Carrying out computed tomography (CT) usually cannot detect the presence of a brain aneurysm, and when performing an IV thrombolysis according to the current protocol, there is a real possibility that it will occur in conditions of comorbidity with brain aneurysm. On the other hand, a history or the establishment of a brain aneurysm is not an absolute contraindication to specific treatment for AIS. Of particular relevance to clinical practice is the question about the aneurysm characteristics and about the patient characteristics that make reccomended to perform IV thrombolysis and when specific treatment is not recommended.
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Copyright (c) 2019 Dobrinka Kalpachka, T. Sakelarova, R. Kalpachki
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