CASE REPORT / SHORT REPORT   Open access

Italian Journal of Emergency Medicine 2020 April;9(1):55-7

DOI: 10.23736/S2532-1285.20.00006-3

Copyright © 2020 THE AUTHORS

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language: English

Repeated thrombolysis after early recurrent ischemic stroke within 48 hours

Roberta ROMUALDI ^{1, 2}, Maurizio ASSETTA ², Paolo CERRONE ¹, Alfonsina CASALENA ², Matteo DI GIUSEPPE ², Samanta SCIAMANNA ², Clara BALSANO ¹ ✉

¹ Department of Clinical Medicine, Life, Health and Environmental Sciences-MESVA, University of L’Aquila, L’Aquila, Italy; ² Unit of Neurology-Stroke, Giuseppe Mazzini Hospital, Teramo, Italy

Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator is effective and safe in acute ischemic stroke. Repeated IVT for early recurrent stroke is currently contraindicated in stroke guidelines of American Heart Association and American Stroke Association (AHA/ASA), due to the high risk of intracerebral hemorrhage. Several recent studies suggest that repeated IVT may be one of the therapeutic options when secondary prevention fails. We described a case of two systemic thrombolysis treatments within 48 hours in a patient with early ischemic stroke recurrence, in which a significant neurologic improvement was obtained despite the appearance of a small subarachnoid hemorrhage.

KEY WORDS: Stroke; Tissue plasminogen activator; Mechanical thrombolysis