Intracranial haemorrhage 4 days after receiving thrombolytic therapy in a young woman with myocardial infarction

BMJ Case Rep. 2013 May 22:2013:bcr2013009816. doi: 10.1136/bcr-2013-009816.

Abstract

Intracranial haemorrhage is a known complication after fibrinolytic therapy and occurs usually in the first 24 h. We report a 35-year-old woman who presented with severe central chest pain and she was diagnosed as anterior ST elevation myocardial infarction. She was given fibrinolytic therapy with Tenecteplase. She responded well to the treatment with a decrease in the intensity of chest pain and resolution of the ST segment elevation. She was taken for coronary angiogram the next day, which revealed an occlusion of the left anterior descending (LAD) artery, and stenting of LAD was carried out. Four days later, she developed severe headache, confusion, slurring of speech and right haemiparesis. CT brain revealed intracerebral haemorrhage and she was referred to an neurosurgeon who advised for conservative management. Her condition gradually improved with physiotherapy and was discharged home with no marked functional impairment.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Chest Pain / diagnosis*
  • Chest Pain / etiology
  • Coronary Occlusion / surgery
  • Female
  • Fibrinolytic Agents / adverse effects*
  • Humans
  • Intracranial Hemorrhages / chemically induced*
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / drug therapy*
  • Myocardial Infarction / surgery
  • Tenecteplase
  • Thrombolytic Therapy / adverse effects*
  • Tissue Plasminogen Activator / adverse effects*

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator
  • Tenecteplase