SAFETY OF INTRAVENOUS THROMBOLYSIS IN AN ACUTE ISCHEMIC STROKE PATIENT WITH SEVERE HEMOPTYSIS DUE TO UNDERLYING BRONCHIECTASIS

Abstract

Introduction: Despite that bronchiectasis has been mentioned in patients with even fatal complications
of intravenous thrombolysis (IVT) for myocardial infarction, the safety of IVT administration in patients with
known bronchiectasis and acute ischemic stroke (AIS) is not established.
Methods: We present the case of a 74-year-old woman who received intravenous thrombolysis for AIS
despite recent hemoptysis due to underlying bronchiectasis.
Results: A 74-year-old patient with recent (8 hours) hemoptysis due to extensive underlying bronchiectasis
presented with acute left hemiplegia, dysarthria, gaze deviation and decreased level of consciousness
(NIHSS-Score on admission: 22) within 75 min from symptom onset. She was treated successfully with IVT,
resulting in substantial neurological improvement. (Discharge-NIHSS: 2). Neuroimaging studies disclosed
infarctions in different arterial territories, without hemorrhagic complications, while cardiac monitoring
revealed paroxysmal atrial fibrillation (AF) as the underlying stroke etiology.
Discussion: The present case highlights that systemic thrombolysis for AIS despite recent hemoptysis
due to underlying bronchiectasis appears to be safe.