Post-tPA Hemorrhage in CVA

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Background

  • Consider if pt develops:
    • Decreased LOC
    • Increased weakness
    • New headache
    • Sudden rise in BP

Management

  • Stop tPA
  • Head CT
    • If no bleeding: resume tPA
    • If bleeding:
      • Consider fibrinogen replacement
      • Recheck CBC, coags fibrinogen levels
      • Prepare 6-8 units cryoprecipitate
      • Prepare 6-8 units platelets

See Also

References