Catastrophic Intracranial Hemorrhages after IV tPA in a Patient with Insidious Onset of Fever and Back Pain

Steven Tversky; Richard B. Libman; Evan R. Schloss; Rohan Arora; Anand V. Patel; Elliot J. Salamon; Paul Wright; Jeffrey M. Katz

doi:10.1016/j.jstrokecerebrovasdis.2015.12.004

Catastrophic Intracranial Hemorrhages after IV tPA in a Patient with Insidious Onset of Fever and Back Pain

Steven Tversky, Richard B. Libman, Evan R. Schloss, Rohan Arora, Anand V. Patel, Elliot J. Salamon, Paul Wright, Jeffrey M. Katz

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Infective endocarditis is associated with unstable infective vegetations, which have a propensity to embolize and cause embolic events, such as stroke. Many cases present with an embolic event as the first sign of infective endocarditis. We present a patient who had a history of recent and persistent fever, an acute ischemic stroke treated with intravenous tissue plasminogen activator (IV tPA), and severe, multifocal intracerebral hemorrhage as a complication of tPA treatment. Suspected infective endocarditis in a stroke patient should most likely be considered a contraindication to IV tPA.

Original language	English (US)
Pages (from-to)	e69-e70
Journal	Journal of Stroke and Cerebrovascular Diseases
Volume	25
Issue number	5
DOIs	https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.12.004
State	Published - May 1 2016
Externally published	Yes

Keywords

Stroke
endocarditis
infectious disease
septic emboli
tPA

ASJC Scopus subject areas

Surgery
Rehabilitation
Clinical Neurology
Cardiology and Cardiovascular Medicine

Access to Document

10.1016/j.jstrokecerebrovasdis.2015.12.004

Cite this

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title = "Catastrophic Intracranial Hemorrhages after IV tPA in a Patient with Insidious Onset of Fever and Back Pain",

abstract = "Infective endocarditis is associated with unstable infective vegetations, which have a propensity to embolize and cause embolic events, such as stroke. Many cases present with an embolic event as the first sign of infective endocarditis. We present a patient who had a history of recent and persistent fever, an acute ischemic stroke treated with intravenous tissue plasminogen activator (IV tPA), and severe, multifocal intracerebral hemorrhage as a complication of tPA treatment. Suspected infective endocarditis in a stroke patient should most likely be considered a contraindication to IV tPA.",

keywords = "Stroke, endocarditis, infectious disease, septic emboli, tPA",

author = "Steven Tversky and Libman, {Richard B.} and Schloss, {Evan R.} and Rohan Arora and Patel, {Anand V.} and Salamon, {Elliot J.} and Paul Wright and Katz, {Jeffrey M.}",

note = "Publisher Copyright: {\textcopyright} 2016 National Stroke Association.",

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doi = "10.1016/j.jstrokecerebrovasdis.2015.12.004",

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T1 - Catastrophic Intracranial Hemorrhages after IV tPA in a Patient with Insidious Onset of Fever and Back Pain

AU - Tversky, Steven

AU - Libman, Richard B.

AU - Schloss, Evan R.

AU - Arora, Rohan

AU - Patel, Anand V.

AU - Salamon, Elliot J.

AU - Wright, Paul

AU - Katz, Jeffrey M.

PY - 2016/5/1

Y1 - 2016/5/1

N2 - Infective endocarditis is associated with unstable infective vegetations, which have a propensity to embolize and cause embolic events, such as stroke. Many cases present with an embolic event as the first sign of infective endocarditis. We present a patient who had a history of recent and persistent fever, an acute ischemic stroke treated with intravenous tissue plasminogen activator (IV tPA), and severe, multifocal intracerebral hemorrhage as a complication of tPA treatment. Suspected infective endocarditis in a stroke patient should most likely be considered a contraindication to IV tPA.

AB - Infective endocarditis is associated with unstable infective vegetations, which have a propensity to embolize and cause embolic events, such as stroke. Many cases present with an embolic event as the first sign of infective endocarditis. We present a patient who had a history of recent and persistent fever, an acute ischemic stroke treated with intravenous tissue plasminogen activator (IV tPA), and severe, multifocal intracerebral hemorrhage as a complication of tPA treatment. Suspected infective endocarditis in a stroke patient should most likely be considered a contraindication to IV tPA.

KW - Stroke

KW - endocarditis

KW - infectious disease

KW - septic emboli

KW - tPA

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Catastrophic Intracranial Hemorrhages after IV tPA in a Patient with Insidious Onset of Fever and Back Pain

Abstract

Keywords

ASJC Scopus subject areas

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