CT patterns of intracranial hemorrhage complicating thrombolytic therapy for acute myocardial infarction

J. P. Uglietta, C. M. O'Connor, O. B. Boyko, H. Aldrich, E. W. Massey, E. R. Heinz

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Computed tomographic (CT) patterns of intracranial hemorrhage (ICH) were determined in 1,696 patients undergoing thrombolytic therapy for acute myocardial infarction. ICH occurred at 33 sites in 0.77% of patients (n = 13). Thirty-six percent of hemorrhages (n = 12) were intraparenchymal, 33% (n = 11) were subdural, 24% (n = 8) were subarachnoid, and 6% (n = 2) were intraventricular. Eighty-four percent (n = 26) of all nonventricular hemorrhages were supratentorial in location. The most common site of ICH was supratentorial and intraparenchymal (10 of 33). In 11 of the 13 patients with ICH, clinical symptoms occurred within 24 hours of the initiation of thrombolytic therapy. A fatal outcome resulted in three of the four patients who had clinical symptoms within 3.5 hours after beginning thrombolytic therapy. The CT findings of multiple intracranial bleeding sites, substantial mass effect with midline shift, and large-volume intraparenchymal hematomas were associated with increased mortality. ICH associated with thrombolytic therapy for acute myocardial infarction has a grave prognosis, with 62% of patients dying during hospitalization.

Original languageEnglish (US)
Pages (from-to)555-559
Number of pages5
JournalRadiology
Volume181
Issue number2
DOIs
StatePublished - Jan 1 1991

Keywords

  • Brain, CT
  • Brain, hemorrhage
  • Myocardium, infarction
  • Thrombolysis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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