Clinical features and outcomes in acute ischemic stroke patients with remote symptomatic intracranial hemorrhage after intravenous thrombolysis

Objective To investigate clinical features and outcomes in acute ischemic stroke patients with remote symptomatic intracranial hemorrhage (sICHr) after intravenous thrombolysis. Methods The acute ischemic stroke patients with sICHr after intravenous thrombolysis therapy were enrolled retrospectively. The clinical data were collected and the related literature was analyzed and summarized. Results A total of 6 acute ischemic stroke patients with sICHr were enrolled, including 4 males. Three patients had a history of using antiplatelet agents, 2 with atrial fibrillation, 4 with hypertension, 3 with previous stroke history, 4 with smoking history, and 4 had sICHr at 2 h after intravenous thrombolysis. Of the 14 hemorrhagic foci (except in the infarct areas), 10 were in the cerebral cortex. Three patients died within 1 week, and 1 was in a persistent vegetative state. Conclusions SICHr after intravenous thrombolysis in patients with acute ischemic stroke is mainly located in the cerebral cortex. The outcomes in acute ischemic stroke patients with SICHr after intravenous thrombolysis are poor, and the mortality is high.