Post-tPA hemorrhage in CVA - Revision history

Danbot: Danbot moved page Post-tPA Hemorrhage in CVA to Post-tPA hemorrhage in CVA without leaving a redirect: Naming convention: first word capitalized, subsequent words lowercase

2026-03-22T05:33:50Z

Danbot moved page Post-tPA Hemorrhage in CVA to Post-tPA hemorrhage in CVA without leaving a redirect: Naming convention: first word capitalized, subsequent words lowercase

← Older revision	Revision as of 05:33, 22 March 2026
(No difference)

2026-03-20T21:08:26Z

Add MedicationDose entry for tranexamic acid

@@ Line 22: / Line 22: @@
 **STAT neurosurgery consult
 **Consider TXA 15 mg/kg IV in 250 ml x 20 min if ongoing hemorrhage after above measures
 ==See Also==

2019-11-27T20:42:43Z

Management

← Older revision		Revision as of 20:42, 27 November 2019
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	==Management==		==Management==
	*Stop tPA		*Immediately Stop tPA, even on suspicion of post-tPA hemorrhage
	*[[Head CT]]		*STAT [[Head CT]]
	**If no bleeding: resume tPA		*If no bleeding: resume tPA
	**~~If bleeding~~:		*If post-tPA ICH present
	***Consider fibrinogen replacement		**Obtain baseline labs: CBC, D-dimer, type and screen, fibrinogen. Check INR 15 minutes after FFP administration (see below) and platelets 15 min after platelet administration (see below)
	***~~Recheck CBC~~, ~~coags fibrinogen levels~~		**Administer cryoprecipitate 10 units for fibrinogen replacement
	***~~Prepare 6~~-~~8 units [[cryoprecipitate]]~~		***If fibrinogen returns > 150, discontinue, if < 150, recheck in 1 hr and if still low administer additional 20 units
	***~~Prepare 6-8 units [[~~platelets]]		**Administer FFP 20 ml/kg
			***If INR > 1.4, give additional 20 ml/kg)
			**Administer 2-5 packs platelets
			***If platelets <100,000, give additional PRN to achieve Plt > 100,000
			**STAT neurosurgery consult
			**Consider TXA 15 mg/kg IV in 250 ml x 20 min if ongoing hemorrhage after above measures

	==See Also==		==See Also==

2019-11-27T20:25:53Z

Background

← Older revision		Revision as of 20:25, 27 November 2019
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	*Consider post-tPA [[ICH]] if patient develops:		*Consider post-tPA [[ICH]] if patient develops:
	**[[AMS\|Decreased LOC]]		**[[AMS\|Decreased LOC]]
			**Worsening neurologic exam
	**Increased [[weakness]]		**Increased [[weakness]]
	**New [[headache]]		**New [[headache]]

2019-10-03T04:30:48Z

← Older revision		Revision as of 04:30, 3 October 2019
Line 1:		Line 1:
	==Background==		==Background==
	*Consider if patient develops:		*Consider post-tPA [[ICH]] if patient develops:
	**Decreased LOC		**[[AMS\|Decreased LOC]]
	**Increased weakness		**Increased [[weakness]]
	**New headache		**New [[headache]]
	**Sudden rise in BP		**Sudden rise in [[hypertension\|BP]]
			*May also have [[GI bleed]], mucosal bleeding

	==Management==		==Management==
	*Stop tPA		*Stop tPA
	*Head CT		*[[Head CT]]
	**If no bleeding: resume tPA		**If no bleeding: resume tPA
	**If bleeding:		**If bleeding:
	***Consider fibrinogen replacement		***Consider fibrinogen replacement
	***Recheck CBC, coags fibrinogen levels		***Recheck CBC, coags fibrinogen levels
	***Prepare 6-8 units cryoprecipitate		***Prepare 6-8 units [[cryoprecipitate]]
	***Prepare 6-8 units platelets		***Prepare 6-8 units [[platelets]]

	==See Also==		==See Also==
Line 23:		Line 24:
	<references/>		<references/>
	[[Category:Neurology]]		[[Category:Neurology]]
			[[Category:Critical Care]]

2017-07-24T01:13:30Z

Text replacement - "==References== " to "==References== <references/> "

2016-07-01T19:26:39Z

Text replacement - " pt " to " patient "

← Older revision		Revision as of 19:26, 1 July 2016
Line 1:		Line 1:
	==Background==		==Background==
	*Consider if pt develops:		*Consider if patient develops:
	**Decreased LOC		**Decreased LOC
	**Increased weakness		**Increased weakness

2016-03-22T14:14:31Z

Text replacement - "Category:Neuro" to "Category:Neurology"

2016-02-16T03:42:51Z

← Older revision		Revision as of 03:42, 16 February 2016
Line 13:		Line 13:
	***Consider fibrinogen replacement		***Consider fibrinogen replacement
	***Recheck CBC, coags fibrinogen levels		***Recheck CBC, coags fibrinogen levels
	***Prepare 6-8 units cryoprecipitate ~~or FFP~~		***Prepare 6-8 units cryoprecipitate
	***Prepare 6-8 units platelets		***Prepare 6-8 units platelets

2016-02-16T03:40:11Z

← Older revision		Revision as of 03:40, 16 February 2016
Line 13:		Line 13:
	***Consider fibrinogen replacement		***Consider fibrinogen replacement
	***Recheck CBC, coags fibrinogen levels		***Recheck CBC, coags fibrinogen levels
	***Prepare 6-8 units cryoprecipitate		***Prepare 6-8 units cryoprecipitate or FFP
	***Prepare 6-8 units platelets		***Prepare 6-8 units platelets