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Academia Mexicana de Neurología, A.C.

2018, Number 4

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Rev Mex Neuroci 2018; 19 (4)

Remote cerebellar haemorrhage after thrombolysis

Lambea-Gil Á, Tejada-Meza H, Serrano-Ponz M, Marta-Moreno J

Language: Spanish
References: 12
Page: 108-114
PDF size: 733.14 Kb.


ABSTRACT

Introduction: Intracerebral haemorrhage after intravenous thrombolysis is a relevant complication of ischaemic stroke. Its mechanisms are not well known; making a distinction between haemorrhagic transformation of the ischemic region and hematomas unrelated to that area, referred to as remote intracerebral haemorrhage (rICH).
Case report: An 84-year-old male, independent in all activities of daily living with hypertension as a cardiovascular risk factor suffers abruptly from aphasia and right faciobrachial hemiparesis. Cerebral Computed Tomography (CT) does not show any findings of bleeding or acute ischemia. Intravenous thrombolysis is administrated in the absence of contraindication. After 24 hours, control CT showed a parenchymatous haemorrhage in the right cerebellar amygdala and no signs of haemorrhagic transformation of the infarct. Follow-up Magnetic Resonance imaging showed the absorption of the cerebellar hematoma, without signs of previous ischemia in that location.
Conclusion: rICH is not an uncommon post-thrombolytic complication and its long-term morbidity and mortality is considerable. The finding would force us to think about small vessel disease with hypertensive microangiopathy as one of the main predisposing factors of cerebellar rICH, in contrast with lobar rICH, more related with leucoaraiosis, amyloid angiopathy and microbleeds.


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