Published: June 2009

Unruptured Cerebral Aneurysm Detected after Intravenous Tissue Plasminogen Activator for Stroke
Yukihiro Yoneda^a, Shinji Yamamoto^a, Yoshie Hara^b, Haruo Yamashita^b

Division of
^aNeurology and
^bNeurosurgery, Kobe Red Cross Hospital and Hyogo Emergency Medical Center, Kobe City, Japan

Address of Corresponding Author

Case Rep Neurol 2009;1:20-23 (DOI: 10.1159/000224714)

  Key Words

• Aneurysm
• Stroke
• Thrombolysis
• Tissue plasminogen activator

  Abstract

Therapeutic guidelines of intravenous thrombolysis with tissue plasminogen activator (tPA) for hyperacute ischemic stroke are very strict. Because of potential higher risk of bleeding complications, the presence of unruptured cerebral aneurysm is a contraindication for systemic thrombolysis with tPA. According to the standard CT criteria, a 66-year-old woman who suddenly developed aphasia and hemiparesis received intravenous tPA within 3 h after ischemic stroke. Magnetic resonance angiography during tPA infusion was performed and the presence of a small unruptured cerebral aneurysm was suspected at the anterior communicating artery. Delayed cerebral angiography confirmed an aneurysm with a size of 7 mm. The patient did not experience any adverse complications associated with the aneurysm. Clinical experiences of this kind of accidental off-label thrombolysis may contribute to modify the current rigid tPA guidelines for stroke.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Yukihiro Yoneda, MD
Division of Neurology, Kobe Red Cross Hospital
1-3-1 Wakinohama Bay Street, Chuo WardKobe City, 651-0073 (Japan)
Tel. +81 78 231 6006, Fax +81 78 241 7053, E-Mail y-yoneda@kobe.jrc.or.jp

  Article Information

Published online: June 20, 2009
Number of Print Pages : 4
Number of Figures : 1,