Skip to content
Research Article Open access CC BY 4.0

Ischemic Stroke Following Thrombolytic Therapy for Acute Inferior Myocardial Infarction: The Third Reported Case

A. Abouriche, H. Bendahou, L. Laklalech, M. HABOUB, S. AROUS, G. Bennouna, A. DRIGHIL, L. Azzouzi, R. HABBAL

Cardiology and Angiology: An International Journal · pp. 479–484 · Published 22 Dec 2022

10.9734/ca/2022/v11i4303

Abstract

Background: Ischemic stroke following thrombolysis for ST-segment elevation myocardial infarction(STEMI) is a rare and perplexing complication. We present an intriguing case of ischemic stroke following fibrinolytic therapy with tenecteplase for a STEMI. This is an extremely rare condition, and our case appears to be the third one reported in our departement. The three cases had one thing in common: ST-segment elevation in the inferior leads. Case Presentation: We describe the case of a 50-year-old north-african woman who suffered an acute inferior STEMI 6 hours after chest pain onset. Thrombolysis with tenecteplase was performed and few hours later an extensive right sylvian artery stroke occurred with subfalcine herniation. Decision-Making: The refractory intracranial hypertension despite medical therapy compelled a decompressive craniectomy. On the follow up, neurological deficits had increased, congestive heart failure developed, and finally the patient died on the tenth day in the intensive care unit. Conclusion: Hemorrhagic complications are not the only one, ischemic stroke can also occur after thrombolysis even if it is extremely odd. The pathophysiology is still poorly established. The prevalent implication of the inferior territory in the three cases described in the literature may open to future research prospects.

Acute ST-elevation myocardial infarction thrombolytic therapy ischemic stroke complication of treatment

References (13)

  1. 1 Early Signs of Brain Infarction at CT: Observer Reliability and Outcome after Thrombolytic Treatment—Systematic Review [DOI]
  2. 2 The Incidence of Stroke after Myocardial Infarction: A Meta-Analysis [DOI]
  3. 3 Incidence, Trends, and Predictors of Ischemic Stroke 30 Days After an Acute Myocardial Infarction [DOI]
  4. 4 Short-term outcome in ischemic stroke patients after thrombolytic therapy [DOI]
  5. 5 Incidence and characteristics of stroke during 90-day follow-up in patients stabilized after an acute coronary syndrome [DOI]
  6. 6 Risk of Ischemic Stroke After an Acute Myocardial Infarction in Patients With Diabetes Mellitus [DOI]
  7. 7 Thrombolytic Therapy in Wake-Up Stroke Patients [DOI]
  8. 8 Frequency and prognosis of stroke/TIA among 4808 survivors of acute myocardial infarction. The SPRINT Study Group. [DOI]
  9. 9 Patient characteristics and comorbidities associated with cerebrovascular accident following acute myocardial infarction in the United States [DOI]
  10. 10 Ischemic Cerebral Infarction After rt-PA and Heparin Therapy for Acute Myocardial Infarction [DOI]
  11. 11 Ischemic stroke complicating thrombolytic therapy with tenecteplase for ST elevation myocardial infarction: two case reports [DOI]
  12. 12 Cerebral embolism following thrombolytic therapy for acute myocardial infarction: the second reported case.
  13. 13 Paradoxical Myocardial Infarction After Thrombolytic Therapy for Acute Ischemic Stroke [DOI]

Cited by 1

Paradoxical Ischemic Stroke Following Streptokinase Fibrinolysis in STEMI: A Cardio-Cerebral Infarction Series from a Limited-Resource Setting

Wilbert Huang, Ryzufar Altarif Farsal, H. J. M. Charlex · Indonesian Journal of Cardiology · 2026

Related research

Article metrics

Real usage data collected on this platform.

73

Page views

0

PDF downloads

42

Outbound clicks

1

Citations

Views over time

Views by country

Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".

Traffic sources

Referring site, by host.

Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.