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Treatment of Intracerebral Hemorrhage with Tranexamic Acid After Thrombolysis with Tissue Plasminogen Activator.
MedLine Citation:
PMID:  22311234     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Thrombolytic treatment with intravenous tissue plasminogen activator (iv tPA) is the only FDA-approved therapy for acute ischemic stroke. There are risks associated with thrombolytics, including intracranial and extracranial hemorrhage and hypersensitivity reactions. Established treatment for post-tPA hemorrhage includes administration of blood products including cryoprecipitate, fresh frozen plasma, and platelets which have poorly established efficacy. Tranexamic acid (TXA) and epsilon-aminocaproic acid (EACA) have been studied as hemostatic therapies in post-operative hemorrhage, menorrhagia, intracranial hemorrhage (ICH), subarachnoid hemorrhage, and trauma patients. There is no reported literature on the use of TXA to reverse thrombolytic therapy with tPA. METHODS: This is a case report of a Jehovah's Witness patient who was unwilling to receive blood products after developing symptomatic ICH following iv tPA. He consequently received TXA for reversal of thrombolytic therapy. RESULTS: The patient received a total of 1.675 g of iv TXA within 3 h of finishing the iv tPA. Repeat brain imaging with computed tomography and magnetic resonance imaging revealed no further expansion of hemorrhages. CONCLUSION: TXA is an inexpensive medication which competitively inhibits the activation of plasminogen and can be given to reverse thrombolysis in the setting of hemorrhage after iv thrombolytic therapy.
Authors:
K F French; Jacob White; R E Hoesch
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-7
Journal Detail:
Title:  Neurocritical care     Volume:  -     ISSN:  1556-0961     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101156086     Medline TA:  Neurocrit Care     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Neurology, Clinical Neurosciences Center, University of Utah School of Medicine, 175 N Medical Drive East, Salt Lake City, UT, Utah, 84132, Kris.french@hsc.utah.edu.
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