急性缺血性卒中静脉溶栓后前交通动脉动脉瘤破裂：一例报告
Rupture of Anterior Communicating Artery Aneurysm after Intravenous Thrombolysis for Acute Ischemic Stroke: A Case Report.
作者信息
Tsuji Keiichi, Tsuji Atsushi, Yoshimura Yayoi, Ogawa Nobuhiro, Nakazawa Takuya, Nozaki Kazuhiko
机构信息
Department of Neurosurgery, Shiga University of Medical Science, Otsu, Shiga, Japan.
Department of Neurology, Shiga University of Medical Science, Otsu, Shiga, Japan.
出版信息
J Neuroendovasc Ther. 2021;15(4):240-245. doi: 10.5797/jnet.cr.2020-0053. Epub 2020 Oct 20.
OBJECTIVE
Rupture of intracranial aneurysms after tissue plasminogen activator (t-PA) administration for acute ischemic stroke with an unruptured cerebral aneurysm is rare. We report a case of ruptured cerebral aneurysm after t-PA administration.
CASE PRESENTATION
A 74-year-old woman with dysarthria and left hemiparesis was admitted to our hospital, and acute lacunar infarction was found in the right corona radiata. One hour after t-PA administration, she complained of sudden headache and nausea, and her consciousness level deteriorated. Subarachnoid hemorrhage due to rupture of the anterior communicating aneurysm was confirmed and coil embolization was performed.
CONCLUSION
T-PA administration for acute ischemic stroke with an unruptured cerebral aneurysm risks rupture of the cerebral aneurysm, and careful judgment is needed in each case.
目的
在患有未破裂脑动脉瘤的急性缺血性卒中患者中，给予组织型纤溶酶原激活剂（t-PA）后颅内动脉瘤破裂的情况罕见。我们报告一例t-PA给药后脑动脉瘤破裂的病例。
病例介绍
一名74岁女性，有构音障碍和左侧偏瘫，入住我院，右侧放射冠发现急性腔隙性梗死。给予t-PA一小时后，她主诉突然头痛、恶心，意识水平下降。确诊为前交通动脉瘤破裂导致蛛网膜下腔出血，并进行了弹簧圈栓塞治疗。
结论
对患有未破裂脑动脉瘤的急性缺血性卒中患者给予t-PA有导致脑动脉瘤破裂的风险，每种情况都需要仔细判断。
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