Intracranial Hemorrhage Following Thrombolytic Use for Stroke Caused by Infective Endocarditis

Background and Purpose Stroke is one of the most common neurological manifestations of infective endocarditis. The use of intravenous tissue plasminogen activator (t-PA) in the management of acute ischemic stroke is the accepted standard of practice. Current guidelines for intravenous (IV) t-PA ther...

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Veröffentlicht in:Neurocritical care 2010-02, Vol.12 (1), p.79-82
Hauptverfasser: Bhuva, Parita, Kuo, Sheng-Han, Claude Hemphill, J., Lopez, George A.
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container_title Neurocritical care
container_volume 12
creator Bhuva, Parita
Kuo, Sheng-Han
Claude Hemphill, J.
Lopez, George A.
description Background and Purpose Stroke is one of the most common neurological manifestations of infective endocarditis. The use of intravenous tissue plasminogen activator (t-PA) in the management of acute ischemic stroke is the accepted standard of practice. Current guidelines for intravenous (IV) t-PA therapy in acute ischemic stroke do not exclude patients with infective endocarditis. Summary of the Case We present three patients who received IV t-PA for acute ischemic stroke in the setting of infective endocarditis and developed multifocal intracranial hemorrhage as a complication. Conclusion Infective endocarditis related strokes are associated with a higher risk of hemorrhagic complications and our experience suggests that IV t-PA use may potentiate that risk.
doi_str_mv 10.1007/s12028-009-9253-5
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The use of intravenous tissue plasminogen activator (t-PA) in the management of acute ischemic stroke is the accepted standard of practice. Current guidelines for intravenous (IV) t-PA therapy in acute ischemic stroke do not exclude patients with infective endocarditis. Summary of the Case We present three patients who received IV t-PA for acute ischemic stroke in the setting of infective endocarditis and developed multifocal intracranial hemorrhage as a complication. Conclusion Infective endocarditis related strokes are associated with a higher risk of hemorrhagic complications and our experience suggests that IV t-PA use may potentiate that risk.</description><identifier>ISSN: 1541-6933</identifier><identifier>EISSN: 1556-0961</identifier><identifier>DOI: 10.1007/s12028-009-9253-5</identifier><identifier>PMID: 19688612</identifier><language>eng</language><publisher>New York: Humana Press Inc</publisher><subject>Aged ; Aneurysms ; Antibiotics ; Aphasia ; Blood ; Cerebral Angiography ; Cerebral Infarction - diagnosis ; Cerebral Infarction - drug therapy ; Cerebral Infarction - etiology ; Corynebacterium Infections - complications ; Councils ; Critical Care Medicine ; Drug use ; Endocarditis ; Endocarditis, Bacterial - complications ; Female ; Fibrinolytic Agents - adverse effects ; Fibrinolytic Agents - therapeutic use ; Hemorrhage ; Humans ; Hypertension ; Infusions, Intravenous ; Intensive ; Internal Medicine ; Intracranial Hemorrhages - chemically induced ; Intracranial Hemorrhages - diagnosis ; Ischemia ; Leukocytes ; Male ; Medicine ; Medicine &amp; Public Health ; Middle Aged ; Neurology ; Patients ; Practical Pearl ; Streptococcal Infections - complications ; Stroke ; Subarachnoid Hemorrhage - chemically induced ; Subarachnoid Hemorrhage - diagnosis ; Thrombolytic Therapy - adverse effects ; Tissue Plasminogen Activator - adverse effects ; Tissue Plasminogen Activator - therapeutic use ; Tomography, X-Ray Computed ; Ultrasonic imaging ; Viridans Streptococci</subject><ispartof>Neurocritical care, 2010-02, Vol.12 (1), p.79-82</ispartof><rights>Humana Press Inc. 2009</rights><rights>Humana Press Inc. 2009.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c501t-51e153ad36940bab6fa2740f52573bcb61280b34283b7d90869b770d70d2fe4a3</citedby><cites>FETCH-LOGICAL-c501t-51e153ad36940bab6fa2740f52573bcb61280b34283b7d90869b770d70d2fe4a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12028-009-9253-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2920283560?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,780,784,885,21388,21389,27924,27925,33530,33531,33744,33745,41488,42557,43659,43805,51319,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19688612$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bhuva, Parita</creatorcontrib><creatorcontrib>Kuo, Sheng-Han</creatorcontrib><creatorcontrib>Claude Hemphill, J.</creatorcontrib><creatorcontrib>Lopez, George A.</creatorcontrib><title>Intracranial Hemorrhage Following Thrombolytic Use for Stroke Caused by Infective Endocarditis</title><title>Neurocritical care</title><addtitle>Neurocrit Care</addtitle><addtitle>Neurocrit Care</addtitle><description>Background and Purpose Stroke is one of the most common neurological manifestations of infective endocarditis. The use of intravenous tissue plasminogen activator (t-PA) in the management of acute ischemic stroke is the accepted standard of practice. Current guidelines for intravenous (IV) t-PA therapy in acute ischemic stroke do not exclude patients with infective endocarditis. Summary of the Case We present three patients who received IV t-PA for acute ischemic stroke in the setting of infective endocarditis and developed multifocal intracranial hemorrhage as a complication. 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The use of intravenous tissue plasminogen activator (t-PA) in the management of acute ischemic stroke is the accepted standard of practice. Current guidelines for intravenous (IV) t-PA therapy in acute ischemic stroke do not exclude patients with infective endocarditis. Summary of the Case We present three patients who received IV t-PA for acute ischemic stroke in the setting of infective endocarditis and developed multifocal intracranial hemorrhage as a complication. Conclusion Infective endocarditis related strokes are associated with a higher risk of hemorrhagic complications and our experience suggests that IV t-PA use may potentiate that risk.</abstract><cop>New York</cop><pub>Humana Press Inc</pub><pmid>19688612</pmid><doi>10.1007/s12028-009-9253-5</doi><tpages>4</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Aneurysms
Antibiotics
Aphasia
Blood
Cerebral Angiography
Cerebral Infarction - diagnosis
Cerebral Infarction - drug therapy
Cerebral Infarction - etiology
Corynebacterium Infections - complications
Councils
Critical Care Medicine
Drug use
Endocarditis
Endocarditis, Bacterial - complications
Female
Fibrinolytic Agents - adverse effects
Fibrinolytic Agents - therapeutic use
Hemorrhage
Humans
Hypertension
Infusions, Intravenous
Intensive
Internal Medicine
Intracranial Hemorrhages - chemically induced
Intracranial Hemorrhages - diagnosis
Ischemia
Leukocytes
Male
Medicine
Medicine & Public Health
Middle Aged
Neurology
Patients
Practical Pearl
Streptococcal Infections - complications
Stroke
Subarachnoid Hemorrhage - chemically induced
Subarachnoid Hemorrhage - diagnosis
Thrombolytic Therapy - adverse effects
Tissue Plasminogen Activator - adverse effects
Tissue Plasminogen Activator - therapeutic use
Tomography, X-Ray Computed
Ultrasonic imaging
Viridans Streptococci
title Intracranial Hemorrhage Following Thrombolytic Use for Stroke Caused by Infective Endocarditis
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