Clark Mark A, Paradis Norman A
Department of Emergency Medicine, St Luke's - Roosevelt Hospital Center, New York, New York, USA.
J Emerg Med. 2002 Oct;23(3):247-51. doi: 10.1016/s0736-4679(02)00546-2.
Patients who receive thrombolytic therapy are at risk of central nervous system (CNS) hemorrhage, and this diagnosis must be sought in any patient who develops neurologic complaints after thrombolysis and anticoagulation. Early imaging and neurosurgical consultation are essential to improve outcome after hemorrhage occurs. We describe a patient who developed spinal epidural hematoma (SEH) after thrombolysis and anticoagulation for acute myocardial infarction. Delay in diagnosis and management may have contributed to a poor outcome. The literature on SEH is reviewed, and approaches to improve the prognosis of patients suffering CNS hemorrhage after thrombolysis are discussed.
