Use of recombinant factor VIIa in symptomatic intracerebral hemorrhage following intravenous thrombolysis

  • Shadi Yaghi | shadiyaghi@yahoo.com Department of Neurology, Columbia University Medical Center, New York, NY, United States.
  • Aya Haggiagi Department of Neurology, Columbia University Medical Center, New York, NY, United States.
  • Ayesha Sherzai Department of Neurology, Columbia University Medical Center, New York, NY, United States.
  • Randolph S. Marshall Department of Neurology, Columbia University Medical Center, New York, NY, United States.
  • Sachin Agarwal Department of Neurology, Columbia University Medical Center, New York, NY, United States.

Abstract

Symptomatic intracerebral hemorrhage (sICH) occurs in up to 7% of stroke patients treated with thrombolytic therapy. There are limited data on the effectiveness of the reversal agents used for intravenous tissue plasminogen activator related intracranial bleeds. We report a patient with sICH following intravenous thrombolysis whose intracerebral hemorrhage continued to expand despite treatment with platelets and cryoprecipitate, needing recombinant factor VIIa use for stabilization before surgical evacuation. Factor VIIa along with routine reversal agents following intravenous thrombolysis related sICH may further enhance clot stability and reduce the risk of hematoma expansion. It could be a bridge to definitive surgical management in those patients.

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Published
2015-06-18
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Issue
Section
Case Reports
Keywords:
Intracerebral hemorrhage, ischemic stroke, thrombolysis, factor VIIa, outcome, expansion.
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How to Cite
Yaghi, S., Haggiagi, A., Sherzai, A., Marshall, R. S., & Agarwal, S. (2015). Use of recombinant factor VIIa in symptomatic intracerebral hemorrhage following intravenous thrombolysis. Clinics and Practice, 5(2). https://doi.org/10.4081/cp.2015.756