Dressing Andrea, Graeter Zina, Bardutzky Juergen
Department of Neurology and Clinical Neuroscience, University Medical Center Freiburg, Freiburg, Germany.
Case Rep Neurol. 2017 Jun 14;9(2):156-160. doi: 10.1159/000477392. eCollection 2017 May-Aug.
We report a case of successful intravenous thrombolysis for a distal middle cerebral artery occlusion shortly after traumatic cardiopulmonary resuscitation due to an episode of ventricular tachycardia. A high prevalence of fatal cardiac arrhythmias in acute stroke patients raises the question of safety when administrating thrombolytic therapy after traumatic cardiopulmonary resuscitation; guidelines do not provide a satisfactory statement about this. Our case suggests that intravenous tissue-type plasminogen activator for acute ischemic stroke can be administered after a thorough risk-to-benefit evaluation without major adverse effects in patients after traumatic cardiopulmonary resuscitation, as bleeding complications seem rare and can be monitored and treated.
我们报告了一例因室性心动过速导致创伤性心肺复苏后不久成功进行静脉溶栓治疗大脑中动脉远端闭塞的病例。急性卒中患者中致命性心律失常的高发生率引发了创伤性心肺复苏后给予溶栓治疗时安全性的问题；指南对此并未给出令人满意的说明。我们的病例提示，对于急性缺血性卒中，在对创伤性心肺复苏后的患者进行全面的风险效益评估后，可以给予静脉组织型纤溶酶原激活剂，且似乎很少出现出血并发症，可进行监测和治疗，不会产生重大不良反应。
