Abstract
We report a case of cervical epidural hematoma after tissue plasminogen activator (tPA) treatment. A 77-year-old woman was admitted with a sudden hemiparesis. The clinical diagnosis showed an acute cerebral ischemic attack and we decided to do systemic tPA thrombolytic therapy. Although the hemiparesis got better 2 hours after tPA administration, nuchal pain and tetraparesis developed 8 hours later. MRI revealed an epidura l hematoma (C3–7) compressing the spinal cord. Therefore we performed emergent laminectomy and removed the hematoma. Her motor dysfunction recovered soon after surgery, but mild dysesthesia and dysuria remained. A spontaneous (non-traumatic) cervical epidural hematoma occurring after tPA is a rare hemorrhagic complication. A proper diagnosis and a prompt treatment are important for favorable outcome. We discuss the entity and problems of cervical epidural hematoma after tPA thrombolysis for acute ischemic cerebral attack.
