Paradoxically accelerated fatal brain herniation following thrombolytic therapy in acute ischemic stroke

Sang Won Han; Seo Hyun Kim; Ha Young Shin; Hye Yeon Choi; Chan Hee Park; Jin Kwon Kim; Ji Hoe Heo

doi:10.1385/NCC:5:1:35

Paradoxically accelerated fatal brain herniation following thrombolytic therapy in acute ischemic stroke

Sang Won Han, Seo Hyun Kim, Ha Young Shin, Hye Yeon Choi, Chan Hee Park, Jin Kwon Kim, Ji Hoe Heo

Department of Neurology

Research output: Contribution to journal › Article › peer-review

Abstract

Introduction: The use of plasminogen activators (PAs) in acute stroke patients has dual effects. PAs are beneficial by dissolving thrombi occluding an artery, but may be harmful by their proteolytic and excitotoxic actions. Methods and Results: We report two patients with a fatal brain herniation who rapidly deteriorated despite the successful recanalization and the sustained arterial patency or blood flow. Imaging studies taken after the thrombolytic treatment suggested early occurrence of cellular damage and profound breakdown of the blood - brain barrier. Conclusion: Fatal brain edema occurred after persistent reperfusion by the thrombolytic therapy. Paradoxical thrombolytic-induced injury, which has been suggested in experimental studies, might play a role.

Original language	English
Pages (from-to)	35-38
Number of pages	4
Journal	Neurocritical Care
Volume	5
Issue number	1
DOIs	https://doi.org/10.1385/NCC:5:1:35
Publication status	Published - 2006 Aug

Bibliographical note

Funding Information:
This work was supported by the Korean Science and Engineering Foundation (KOSEF) through National Core Research Center for Nanomedical Technology (R15-2004-024-00000-0).

All Science Journal Classification (ASJC) codes

Critical Care and Intensive Care Medicine
Clinical Neurology

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10.1385/NCC:5:1:35

Cite this

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title = "Paradoxically accelerated fatal brain herniation following thrombolytic therapy in acute ischemic stroke",

abstract = "Introduction: The use of plasminogen activators (PAs) in acute stroke patients has dual effects. PAs are beneficial by dissolving thrombi occluding an artery, but may be harmful by their proteolytic and excitotoxic actions. Methods and Results: We report two patients with a fatal brain herniation who rapidly deteriorated despite the successful recanalization and the sustained arterial patency or blood flow. Imaging studies taken after the thrombolytic treatment suggested early occurrence of cellular damage and profound breakdown of the blood - brain barrier. Conclusion: Fatal brain edema occurred after persistent reperfusion by the thrombolytic therapy. Paradoxical thrombolytic-induced injury, which has been suggested in experimental studies, might play a role.",

author = "Han, {Sang Won} and Kim, {Seo Hyun} and Shin, {Ha Young} and Choi, {Hye Yeon} and Park, {Chan Hee} and Kim, {Jin Kwon} and Heo, {Ji Hoe}",

note = "Funding Information: This work was supported by the Korean Science and Engineering Foundation (KOSEF) through National Core Research Center for Nanomedical Technology (R15-2004-024-00000-0).",

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doi = "10.1385/NCC:5:1:35",

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T1 - Paradoxically accelerated fatal brain herniation following thrombolytic therapy in acute ischemic stroke

AU - Han, Sang Won

AU - Kim, Seo Hyun

AU - Shin, Ha Young

AU - Choi, Hye Yeon

AU - Park, Chan Hee

AU - Kim, Jin Kwon

AU - Heo, Ji Hoe

N1 - Funding Information: This work was supported by the Korean Science and Engineering Foundation (KOSEF) through National Core Research Center for Nanomedical Technology (R15-2004-024-00000-0).

PY - 2006/8

Y1 - 2006/8

N2 - Introduction: The use of plasminogen activators (PAs) in acute stroke patients has dual effects. PAs are beneficial by dissolving thrombi occluding an artery, but may be harmful by their proteolytic and excitotoxic actions. Methods and Results: We report two patients with a fatal brain herniation who rapidly deteriorated despite the successful recanalization and the sustained arterial patency or blood flow. Imaging studies taken after the thrombolytic treatment suggested early occurrence of cellular damage and profound breakdown of the blood - brain barrier. Conclusion: Fatal brain edema occurred after persistent reperfusion by the thrombolytic therapy. Paradoxical thrombolytic-induced injury, which has been suggested in experimental studies, might play a role.

AB - Introduction: The use of plasminogen activators (PAs) in acute stroke patients has dual effects. PAs are beneficial by dissolving thrombi occluding an artery, but may be harmful by their proteolytic and excitotoxic actions. Methods and Results: We report two patients with a fatal brain herniation who rapidly deteriorated despite the successful recanalization and the sustained arterial patency or blood flow. Imaging studies taken after the thrombolytic treatment suggested early occurrence of cellular damage and profound breakdown of the blood - brain barrier. Conclusion: Fatal brain edema occurred after persistent reperfusion by the thrombolytic therapy. Paradoxical thrombolytic-induced injury, which has been suggested in experimental studies, might play a role.

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Paradoxically accelerated fatal brain herniation following thrombolytic therapy in acute ischemic stroke

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

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