Lingual angioedema after alteplase treatment in a patient with acute ischemic stroke

BACKGROUND: In recent years, thrombolytic therapy has become the main treatment of ischemic stroke. But the increasing use of alteplase in ischemic stroke has made some complications more evident. Angioedema is a rare but potentially life-threatening complication of alteplase treatment. Only a few s...

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Bibliographic Details
Published in:World journal of emergency medicine 2015, Vol.6 (1), p.74-76
Main Authors: Bozkurt, Seyran, Arslan, Engin Deniz, Köse, Ataman, Ayrık, Cüneyt, Yılmaz, Arda, Dündar, Güllü Akbaydoğan
Format: Article
Language:English
Subjects:
Airway management
Angioedema
Case Report
Edema
Heart attacks
Ischemia
NMR
Nuclear magnetic resonance
Patients
Stroke
Urine
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Summary:BACKGROUND: In recent years, thrombolytic therapy has become the main treatment of ischemic stroke. But the increasing use of alteplase in ischemic stroke has made some complications more evident. Angioedema is a rare but potentially life-threatening complication of alteplase treatment. Only a few studies have examined the incidence of angioedema after treatment with alteplase for stroke.METHODS: A 75-year-old man complaining of right hemiparesis was admitted to our emergency department. He was diagnosed as having acute ischemic stroke, and alteplase infusion was given two hours after the onset of stroke symptoms. Immediately after the completion of infusion he was noted to have a large swollen tongue.RESULTS: His neurological symptoms resolved gradually within 4 hours, whereas his upper extremity strength improved to 4/5 and lower extremity 5/5. Lingual edema resolved within 16 hours without any complication. He died from presumed nosocomial infection 5 days later.CONCLUSIONS: Lingual angioedema may appear as a possible complication in patients who were treated with alteplase. The management of these patients should be very careful.
ISSN:1920-8642
DOI:10.5847/wjem.j.1920-8642.2015.01.013