Intravenous Tissue Plasminogen Activator Administration for Ischemic Stroke 1 Hour After Epidural Catheter Removal: A Case Report.

作者信息

Baciewicz Anne M, Lee Calvin, Ben-Ari Alon, Kim Hojoong, Lee Alex T

机构信息

From the *VA Puget Sound Health Care System, Department of Pharmacy, University of Washington, Seattle, Washington; †Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; ‡VA Puget Sound Health Care System, Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington; and §VA Puget Sound Health Care System, Department of Neurology, University of Washington, Seattle, Washington.

出版信息

A A Case Rep. 2017 Mar 1;8(5):113-115. doi: 10.1213/XAA.0000000000000443.

DOI:10.1213/XAA.0000000000000443

PMID:28079666

Abstract

Anticoagulation after a recent neuraxial procedure poses risk for development of spinal hematoma. Clinical evidence supports prompt IV tissue plasminogen activator administration after onset of ischemic stroke. There is an absence of data regarding emergency fibrinolytic therapy for patients experiencing a stroke with recent neuraxial procedures, resulting in highly disparate, nonevidence-based guidelines. This report describes a patient who developed ischemic stroke when receiving postoperative epidural analgesia. Tissue plasminogen activator was emergently administered 1 hour after epidural catheter removal with a favorable recovery. The patient and his family reviewed the manuscript, and written consent to publish this case report was obtained from the patient.

摘要