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Case Reports
. 2013 Jan 25:2013:bcr2012007307.
doi: 10.1136/bcr-2012-007307.

Acute stroke in a patient with advanced uraemia: should thrombolysis be given?

Marguerite McCloskey  1 , Agnes Masengu, Joanne Shields, M Ivan Wiggam
Affiliations
Case Reports

Acute stroke in a patient with advanced uraemia: should thrombolysis be given?

Marguerite McCloskey et al. BMJ Case Rep. .

Abstract

A 65-year-old gentleman with stage 5 chronic kidney disease developed an acute posterior circulation stroke, which was treated with intravenous thrombolytic therapy. This was complicated by a retroperitoneal haemorrhage. The patient made an excellent neurological recovery and was discharged to home, independently mobile, having been established on haemodialysis. This case highlights the challenges of managing acute ischaemic stroke in patients with advanced uraemia.

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Figures

Figure 1
Figure 1
CT of the brain showing an old left occipital infarct, age related involutional change and chronic white matter ischaemia.
Figure 2
Figure 2
Repeated CT of the brain at approximately 14 h following the onset of symptoms at the same slice as the previous CT of the brain in figure 1, showing the decreased attenuation in the region of the right thalamus.
Figure 3
Figure 3
CT of the abdomen showing the right sided retroperitoneal haematoma.
Figure 4
Figure 4
x-Ray of the left forearm showing the metal pellet.
See this image and copyright information in PMC

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