Fatal intracranial aneurysm rupture after thrombolytic treatment for ischemic stroke: a case report and literature review.

Beneš, Vladimír; Jurák, Lubomír; Jedlička, Jaroslav; Dienelt, Jan; Suchomel, Petr · Acta Neurochir (Wien) · 2019

case_report · Level V

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Abstract

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.

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