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Unexpected outcome (positive or negative) including adverse drug reactions
CASE REPORT
Simultaneous treatment of ischaemic bowel and ischaemic stroke with intravenous thrombolysis therapy
  1. Lucia Y Chen,
  2. Charlotte Ainscough,
  3. Mohamed Sayed and
  4. Maneesh Bhargava
  1. Hyper-acute stroke unit, University College London Hospitals NHS Foundation Trust, London, UK
  1. Correspondence to Dr Lucia Y Chen, l.chen{at}nhs.net

Abstract

Novel treatment of simultaneous mesenteric and cerebral ischaemia with systemic thrombolysis. A 75-year-old man presented to the acute stroke team with aphasia, right-sided weakness and distressed with a pain he was unable to localise. He was treated with intravenous thrombolysis with tissue plasminogen activator for a left middle cerebral artery stroke. Decompensation on the ward during thrombolysis with worsening abdominal distension and pain, hypotension and tachycardia prompted a CT angiogram scan, which displayed proximal inferior mesenteric artery occlusion. Thrombolysis treatment resulted in excellent improvement of both his dysphasia and weakness from the left cerebral ischaemic stroke and reperfusion of the ischaemic bowel, without surgical intervention.

  • stroke
  • gastrointestinal system

https://doi.org/10.1136/bcr-2018-227126

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    Footnotes

    • Contributors LC and CA gained consent from the patient, wrote the manuscript and contributed equally. The patient was under the care of MB and LC who carried out the investigations. MB and MS edited the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.