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Fatal Intracranial Hemorrhage after Intravenous Thrombolytic Therapy for Acute Ischemic Stroke Associated with Cancer-related Nonbacterial Thrombotic Endocarditis
Nonbacterial thrombotic endocarditis (NBTE) is associated with hypercoagulability in patients with inflammatory states such as cancer and autoimmune diseases. Cardiac vegetations caused by NBTE often lead to life-threatening systemic thromboembolism that most frequently affects the brain, spleen, and kidneys. A 54-year-old woman diagnosed with ovarian cancer suddenly developed back pain and left hemiparesis. Although intravenous alteplase (rt-PA) therapy was administered to treat hyperacute ischemic infarction detected by magnetic resonance imaging, intracranial hemorrhage occurred in the left hemisphere several hours late...
Source: Journal of Stroke and Cerebrovascular Diseases - August 11, 2014 Category: Neurology Authors: Takuya Yagi, Kie Takahashi, Mariko Tanikawa, Morinobu Seki, Takato Abe, Norihiro Suzuki Tags: Case Reports Source Type: research

Successful Intra-arterial Thrombolysis in a Patient with an Intracranial Meningioma
We report a case of a 78-year-old man who was seen in our emergency department within 2 hours from sudden onset of aphasia, right-sided hemiplegia, hypoesthesia, and homonymous hemianopsia. The National Institutes of Health Stroke Scale (NIHSS) score at admission was 20. Intra-arterial thrombolysis was performed with administration of .3 mg/kg of alteplase combined with mechanical thrombectomy. At discharge, his NIHSS score was 1, and after 90 days, his modified Rankin score was 1. To our knowledge, this is the first report of intra-arterial thrombolysis in a patient with acute ischemic stroke with an intracranial tumor.
Source: Journal of Stroke and Cerebrovascular Diseases - July 8, 2013 Category: Neurology Authors: Robson F. Baiense, Agessandro Abrahão, Irapuá F. Ricarte, Thiago G. Fukuda, Ricardo A. Oliveira, Gisele S. Silva, Maristela Costa, Manoel J. Teixeira Tags: Case Reports Source Type: research