Intravenous Thrombolysis in a Severely Thrombocytopenic patient with Internal Carotid Artery Dissection

Jianping Yu, Danni Zheng, Fan Xu, Dengfu Yan and Jie Yang

Department of Neurology, The First Affiliated Hospital of Chengdu Medical College, China
Centre for Big Data Research in Health, University of New South Wales, Australia
The George Institute for Global Health, University of New South Wales, Australia
Department of Public Health, Chengdu Medical College, China

^*Correspondance to: Jie Yang 

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Abstract:

Background: Thrombocytopenia is considered an absolute contraindication for Intravenous Thrombolysis (IVT), according to trial selection criteria and expert opinions. Cases of stroke patients with mild thrombocytopenia who received IVT were occasionally reported, but reports of patients with platelet count below 80,000/μL are scarce.Case
Presentation: We report an ischemic stroke patient with a platelet count of 56,000/μL who received IVT. The patient did not have any hemorrhagic symptoms before stroke and no symptomatic hemorrhagic complications after IVT. The stroke was caused by internal carotid artery dissection, and stenting of the right internal carotid artery was performed to prevent cerebral infarction recurrence.Conclusion: This case exemplifies the need to reassess the threshold of platelet count for withholding intravenous thrombolysis. We often encounter cases with management uncertainties, having no available high-quality evidence. In these cases, clinical decisions must be made on an individual basis.

Keywords:

Thrombocytopenia; Acute ischemic stroke; Intravenous Thrombolysis; Tissue plasminogen activator

Cite the Article:

Yu J, Zheng D, Xu F, Yan D, Yang J. Intravenous Thrombolysis in a Severely Thrombocytopenic patient with Internal Carotid Artery Dissection. Ann Clin Case Rep. 2019; 4: 1594.