• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The Internet Journal of Emergency and Intensive Care Medicine >Hemorrhagic Transformation And A New Ischemic Accident During Thrombolysis Treatment With rtPA
【24h】

Hemorrhagic Transformation And A New Ischemic Accident During Thrombolysis Treatment With rtPA

机译：rtPA溶栓治疗期间的出血性转化和新的缺血性事故

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Administration of intravenous recombinant tissue plasminogen activation ( rtPA ) administered within 3 hours of symptom onset is an effective therapy for acute ischemic stroke (1,2). The efficacy of thrombolysis has been demonstrated despite an increased risk of severe hemorrhagic transformation (HT) in patient treated with rtPA. (3) We report a case of acute ischemic stroke in a woman who during thrombolysis treatment with rtPA suffered an intracerebral haemorrhage and a new ischemic stroke on the opposite side. Case History A 68 year old woman non-smoker was transferred from another hospital to our A&E department 80 minutes after an abrupt onset of left side weakness and difficulty in speaking. Past medical history included hypertension and paroxysmal atrial fibrillation without on aspirin or any other anticoagulant therapy. On arrival in the emergency room, patient underwent standard cardiological and neurological examination. Patient was haemodynamically stable, blood pressure (BP) was 140/60 mm Hg. The ECG revealed atrial fibrillation (AF) with rapid ventricular response while the routine laboratory tests and chest X-Ray were within normal limits. The neurological examination revealed left flaccid hemiplegia, facial weakness and dysarthria 100 min from onset of symptoms. GCS was 14/15 and the corresponding National Institutes of Health Stroke Scale (NIHSS) score was 18 on admission. The AF was reverted back to sinus rhythm by giving 300 mg Amiodarone intravenously. Urgent non-contrast CT scanning was performed which showed normal findings. (Fig 1) Carotid ultrasonography study did not show any occlusion and the cerebral arteries were insonated through the temporal window with a standard Transcranial Doppler ultrasonography (TCD). Spectral wave forms from the proximal middle cerebral artery (MCA) were obtained at a depth of 45 to 65 mm from the left and right transtemporal window. On the right side a minimal, grade 1 signal as measured on the TIBI scale with absent diastolic flow is seen on power-motion Doppler images and spectral-transcranial Doppler images.
机译：在症状发作的3小时内给予静脉内重组组织纤溶酶原激活（rtPA），是治疗急性缺血性中风的有效方法（1,2）。尽管用rtPA治疗的患者发生严重出血转化（HT）的风险增加，但已证明溶栓的功效。 （3）我们报道了一名女性的急性缺血性中风，该患者在接受rtPA溶栓治疗期间发生了脑内出血，另一侧发生了新的缺血性中风。病史一名68岁的女性非吸烟者在突然出现左侧无力和说话困难突然发作80分钟后从另一家医院转移到我们的急诊室。既往病史包括高血压和阵发性房颤，未服用阿司匹林或任何其他抗凝疗法。到达急诊室后，患者接受了标准的心脏和神经系统检查。患者血液动力学稳定，血压（BP）为140/60 mm Hg。心电图显示房颤（AF）具有快速的心室反应，而常规实验室检查和胸部X线检查均在正常范围内。神经系统检查发现症状发作后100分钟左半身偏瘫，面部无力和构音障碍。入院时GCS为14/15，相应的美国国立卫生研究院卒中量表（NIHSS）得分为18。静脉给予300 mg胺碘酮可使房颤恢复为窦律。进行了紧急的非对比CT扫描，结果显示正常。 （图1）颈动脉超声检查未显示任何阻塞，并且使用标准的经颅多普勒超声检查（TCD）通过颞窗对脑动脉进行了声控。在距左和右颞颞窗约45至65 mm的深度处获得了近端中脑动脉（MCA）的光谱波形。在右侧，在动力运动多普勒图像和经颅颅多普勒图像上可以看到最小的1级信号（按TIBI量度，没有舒张血流）。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号