Department of Neurology, Baylor College of Medicine, 6550 Fannin, Suite 1801, Houston, TX 77030, USA.
Neurocrit Care. 2010 Feb;12(1):79-82. doi: 10.1007/s12028-009-9253-5. Epub 2009 Aug 18.
Stroke is one of the most common neurological manifestations of infective endocarditis. The use of intravenous tissue plasminogen activator (t-PA) in the management of acute ischemic stroke is the accepted standard of practice. Current guidelines for intravenous (IV) t-PA therapy in acute ischemic stroke do not exclude patients with infective endocarditis. We present three patients who received IV t-PA for acute ischemic stroke in the setting of infective endocarditis and developed multifocal intracranial hemorrhage as a complication.
Infective endocarditis related strokes are associated with a higher risk of hemorrhagic complications and our experience suggests that IV t-PA use may potentiate that risk.
中风是感染性心内膜炎最常见的神经学表现之一。静脉注射组织型纤溶酶原激活剂（t-PA）治疗急性缺血性中风是公认的标准治疗方法。目前，静脉注射（IV）t-PA 治疗急性缺血性中风的指南并不排除感染性心内膜炎患者。我们报告了 3 例感染性心内膜炎患者在接受 IV t-PA 治疗急性缺血性中风后发生多发性颅内出血的并发症。
感染性心内膜炎相关中风出血并发症的风险较高，我们的经验表明，IV t-PA 的使用可能会增加这种风险。
