Recombinant Tissue Plasminogen Activator Therapy for the Patient with Acute Cerebral Infarction After Endobronchial Ultrasound-guided Transbronchial Needle Aspiration: a Case Report

Abstract

Background. We herein report a patient with acute cerebral infarction after EBUS-TBNA who was successfully treated with recombinant tissue plasminogen activator (rt-PA). Case. A 77-year-old man was admitted due to shortness of breath. The patient had undergone left upper lobectomy for lung cancer one year prior. Chest computed tomography showed pericardial effusion and adenopathy of the subcarinal lymph node. Drainage of the pericardium was performed, and the cytology of the pericardial effusion was negative for malignancy. EBUS-TBNA was performed for the evaluation of the lymphadenopathy. Eight hours after EBUS-TBNA, the patient developed left hemiplegia and was diagnosed with acute cerebral infarction. Under the careful evaluation of stroke specialists, rt-PA was intravenously administrated within four hours of the emergence of symptoms under close observation in the intensive-care unit. Fortunately, the patient did not suffer any bleeding complications. His neurological symptoms gradually improved, and the left hemiplegia eventually disappeared. Conclusion. rt-PA treatment with acute cerebral infarction may be carefully administered after biopsy, but there have been no reports of its administration after EBUS-TBNA. We herein report the first case of intravenous administration of rt-PA for acute cerebral infarction after EBUS-TBNA.