Thrombolysis with recombinant tissue plasminogen activator (rt-PA) is currently the only approved therapy for acute ischemic stroke. However, intracerebral haemorrhage (ICH) remains the most feared and devastating complication of intravenous thrombolysis [
]. We report a case of a patient who suffered a catastrophic haemorrhage following intravenous thrombolysis for stroke, related to previously unsuspected severe cerebral amyloid angiopathy (CAA) found on autopsy.
- Derex L.
- Nighoghossian N.
Intracerebral haemorrhage after thrombolysis for acute ischaemic stroke: an update.
J Neurol Neurosurg Psychiatry. 2008; 79: 1093-1099
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- Intracerebral haemorrhage after thrombolysis for acute ischaemic stroke: an update.J Neurol Neurosurg Psychiatry. 2008; 79: 1093-1099
- Sporadic cerebral amyloid angiopathy revisited: recent insights into pathophysiology and clinical spectrum.J Neurol Neurosurg Psychiatry. 2012; 83: 124-137
- Predicting the risk of symptomatic intracerebral hemorrhage in ischemic stroke treated with intravenous alteplase: safe implementation of treatments in stroke (SITS) symptomatic intracerebral hemorrhage risk score.Stroke. 2012; 43: 1524-1531
- Cerebral amyloid angiopathy and thrombolysis-related intracerebral haemorrhage.Lancet Neurol. 2004; 3: 484-492
- Cerebral amyloid angiopathy related hemorrhage after stroke thrombolysis: case report and literature review.Neuropathology. 2015; 35: 70-74
- Cerebral beta-amyloid detected by Pittsburgh compound B positron emission topography predisposes to recombinant tissue plasminogen activator-related hemorrhage.Ann Neurol. 2010; 68: 959-962
- Cerebral microbleeds and the risk of intracerebral haemorrhage after thrombolysis for acute ischaemic stroke: systematic review and meta-analysis.J Neurol Neurosurg Psychiatry. 2013; 84: 277-280
- Postthrombolysis intracranial hemorrhage risk of cerebral microbleeds in acute stroke patients: a systematic review and meta-analysis.Int J Stroke. 2013; 8: 348-356
- Outcome markers for clinical trials in cerebral amyloid angiopathy.Lancet Neurol. 2014; 13: 419-428
Published online: March 26, 2015
Accepted: March 17, 2015
Received in revised form: March 14, 2015
Received: February 13, 2015
© 2015 Elsevier B.V. Published by Elsevier Inc. All rights reserved.