Department of Neurosurgery, Regional Hospital Liberec, Husova 10, 460 01, Liberec, Czech Republic.
Department of Neurology, Regional Hospital Liberec, Husova 10, Liberec, 460 01, Czech Republic.
Acta Neurochir (Wien). 2019 Jul;161(7):1337-1341. doi: 10.1007/s00701-019-03931-3. Epub 2019 May 7.
Intravenous thrombolysis is a proven treatment of acute ischemic stroke. Its complications include intracranial hemorrhage; the risk may be increased in the presence of an unruptured aneurysm. We present a case report of a patient who suffered fatal subarachnoid hemorrhage after thrombolysis from a known aneurysm. A history of recent previously inexperienced headaches was revealed retrospectively, suggestive of sentinel bleedings. A similar patient was identified in the literature; we thus propose that this history should be excluded in patients harboring an aneurysm considered for thrombolytic treatment.
静脉溶栓是急性缺血性脑卒中的一种已被证实的治疗方法。其并发症包括颅内出血；存在未破裂的动脉瘤时，风险可能会增加。我们报告了一例已知动脉瘤患者溶栓后发生致命性蛛网膜下腔出血的病例。回顾性发现患者有近期未曾经历过的头痛史，提示有哨兵性出血。文献中也有类似的患者被识别出；因此，我们建议在考虑溶栓治疗的动脉瘤患者中应排除这种病史。
