Progression of Acute Ischemic Infarction after a Hemostatic Therapy for Thrombolysis-Related Intracerebral Hemorrhage / 대한뇌졸중학회지

ABSTRACT

As thrombolysis for acute ischemic stroke is a double-edged sword, so could be the hemostatic treatment for thrombolysis-induced intracerebral hemorrhage. An 88-year-old woman with acute ischemic stroke presented with severe dysarthria and right hemiparesis. Her neurological symptoms rapidly improved after intravenous tissue plasminogen activator (t-PA) treatment. However, she became drowsy one hour after the intravenous t-PA treatment. Brain CT revealed a small right thalamic hemorrhage which was contralateral to the initial ischemic lesion. To prevent expansion of the hematoma, vitamine K was infused intravenously. Three hours after the infusion, conjugate eyeball deviation to the left side and right hemiplegia developed, which were likely to be resulted from reocclusion. Hemostatic therapy, such as vitamine K infusion, might be related to the worsening of cerebral ischemia after recanalization with t-PA.