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Open Access Case report

Abdominal wall hemorrhage after intravenous thrombolysis for acute ischemic stroke

Se-A An1, Jinkwon Kim1, Sang Heum Kim2 and Won Chan Kim1*

Author Affiliations

1 Department of Neurology, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-712, Korea

2 Department of Radiology, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-712, Korea

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BMC Neurology 2013, 13:6  doi:10.1186/1471-2377-13-6

Published: 14 January 2013

Abstract

Background

Thrombolysis is strongly recommended for patients with significant neurologic deficits secondary to acute ischemic stroke. Extracranial bleeding is a rare but major complication of thrombolysis.

Case presentation

A 78-year-old woman presented with acute ischemic stroke caused by occlusion of the basilar artery. Clinical recovery was observed after successful recanalization by intravenous thrombolysis and intraarterial thrombectomy. However, the patient complained of sudden abdominal pain following the intervention and a newly developed abdominal wall mass was found. CT scan and selective angiography confirmed active bleeding from the left epigastric artery into the abdominal muscle layer and the bleeding was successfully managed by selective embolization of the bleeding artery.

Conclusions

We report a rare case of abdominal wall hemorrhage after thrombolysis for acute ischemic stroke. The findings indicate that abdominal wall hemorrhage should be considered as a differential diagnosis in the presence of abdominal discomfort after thrombolysis for acute ischemic stroke.

Keywords:
Abdominal wall hemorrhage; Extracranial hemorrhage; Thrombolysis