Post-tPA hemorrhage in CVA: Difference between revisions
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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]] | ||
Revision as of 20:25, 27 November 2019
Background
- Consider post-tPA ICH if patient develops:
- Decreased LOC
- Worsening neurologic exam
- Increased weakness
- New headache
- Sudden rise in BP
- May also have GI bleed, mucosal bleeding
Management
- Stop tPA
- Head CT
- If no bleeding: resume tPA
- If bleeding:
- Consider fibrinogen replacement
- Recheck CBC, coags fibrinogen levels
- Prepare 6-8 units cryoprecipitate
- Prepare 6-8 units platelets