Perfusion Imaging in the 3-hour Time Window Predicts a tPA-associated Hemorrhage in Acute Ischemic Stroke. Issue 3 (February 2015)

• Record Type: Journal Article
• Authors: Rangaraju, Srikant; Edwards, Adam; Dehkharghani, Seena; Nahab, Fadi
• Is Part Of: Neurologist. Volume 19:Issue 3(2015)
• Publication Date: 2015-02
• Subjects: tPA -- tissue plasminogen activator -- intracranial hemorrhage -- symptomatic ICH -- CT perfusion -- CT angiography; Nervous System Diseases -- Periodicals; Nervous system -- Diseases -- Periodicals; Neurologie; 616.8
• DOI: 10.1097/NRL.0000000000000011
• Languages: English
• ISSNs: 1074-7931

Abstract

Abstract : Perfusion imaging is being evaluated in acute ischemic stroke patients to identify those who may benefit from reperfusion therapies beyond the standard thrombolytic time window but limited data are available on its utility in patients presenting within the standard thrombolytic time window. We report a case of a patient presenting within the 3-hour time window where computerized tomographic perfusion imaging before intravenous thrombolysis identified a large volume of severely ischemic tissue and where intravenous tissue plasminogen activator administration subsequently resulted in a fatal intracerebral hemorrhage. Whether perfusion imaging can predict an increased risk of tissue plasminogen activator–associated symptomatic hemorrhage in patients presenting within the standard thrombolytic time window requires further study.