Post-tPA Hemorrhage in CVA

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Background

  1. Consider if pt develops:
    1. Decreased LOC
    2. Increased weakness
    3. New headache
    4. Sudden rise in BP

Management

  1. Stop tPA
  2. Head CT
    1. If no bleeding: resume tPA
    2. If bleeding:
      1. Consider fibrinogen replacement
      2. Recheck CBC, coags fibrinogen levels
      3. Prepare 6-8 units cryoprecipitate
      4. Prepare 6-8 units platelets

See Also

Source

6/06 MISTRY