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BACKGROUND: Stroke thrombolysis-related intracerebral hemorrhage may occur remotely from the anatomical site of ischemia. One postulated mechanism for this is simultaneous multiple embolization with hemorrhage into a "silent" area of ischemia. RESULTS: A patient suffered a disabling stroke affecting the right cerebral hemisphere. He was treated with intravenous alteplase and underwent extensive early imaging with multimodal MRI. Several hours after treatment he developed a brainstem hemorrhage despite having no evidence of ischemia on DWI MRI in the brainstem. CONCLUSION: Not all occurrences of remote ICH after stroke thrombolysis are secondary to multiple emboli with silent ischemia.

Type

Journal article

Journal

BMC Neurol

Publication Date

18/12/2001

Volume

1

Keywords

Aged, Brain Ischemia, Diagnosis, Differential, Fatal Outcome, Fibrinolytic Agents, Humans, Intracranial Hemorrhages, Magnetic Resonance Imaging, Male, Muscle Weakness, Stroke, Tissue Plasminogen Activator, Tomography, X-Ray Computed