Subarachnoid hemorrhage as a complication associated with thrombolysis in a patient with ischemic stroke.

Subarachnoid hemorrhage is a very rare complication of thrombolytic therapy. We report the case of a 76-year- old mestizo woman with a pacemaker, admitted to the emergency room due to compromised consciousness, walking difficulties and dysarthria. She reported a history of poorly controlled hyperten...

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Bibliographic Details
Authors: Rojas-Benites, Mayra, Campos-Flores, Leily, Cancino-Díaz, Juan, Carranza-Jordán, Eduardo, Castillo-Zegarra, Leonardo, Cruz-Rodríguez, José, De la Cruz-Araujo, Waldir
Format: article
Status:Published version
Publication Date:2022
Country:Perú
Institution:Universidad Peruana Cayetano Heredia
Repository:Revistas - Universidad Peruana Cayetano Heredia
Language:Spanish
OAI Identifier:oai:revistas.upch.edu.pe:article/4138
Online Access:https://revistas.upch.edu.pe/index.php/RNP/article/view/4138
Access Level:Open access
Keyword:Stroke
brain ischemia, thrombolytic therapy
subarachnoid hemorrhage
Accidente cerebrovascular
isquemia encefálica
terapia trombolítica
hemorragia subaracnoidea
Description
Summary:Subarachnoid hemorrhage is a very rare complication of thrombolytic therapy. We report the case of a 76-year- old mestizo woman with a pacemaker, admitted to the emergency room due to compromised consciousness, walking difficulties and dysarthria. She reported a history of poorly controlled hypertension, hypothyroidism, and numerous surgical interventions. Based on a non-contrast Multislice Computed Tomography (MSCT) of the brain and the clinical manifestations, a diagnosis of ischemic stroke was established. Thrombolytic therapy with alteplase was immediately started and another non-contrast MSCT brain scan, performed three hours later, identified a subarachnoid hemorrhage as a treatment complication. Twenty-four hours later, a CT angiography confirmed an ischaemic stroke with hemorrhagic transformation, without the presence of a ruptured aneurysm. The patient was admitted to ICU, remaining in observation with permanent control of vital signs, and discharged after 20 days. the patient was discharged. The identification and reporting of this unusual complication contribute to a better understanding and diagnosis of the case.