Retropharyngeal hematoma mimicking angioedema after

Am J Emerg Med · May 2023

Case Reports

Retropharyngeal hematoma mimicking angioedema after intravenous thrombolysis for acute ischemic stroke.

Tissue plasminogen activator (tPA) is a cornerstone treatment for acute ischemic stroke (AIS). Administration of tPA is not without risk, and can provoke life threatening adverse reactions. Retropharyngeal hematoma (RPH) following tPA administration has only been reported after tenecteplase (TNK) administration for ST elevation myocardial infarction (STEMI). ⋯ Following administration of tPA, this patient developed acute signs and symptoms of what appeared to be a more well-known adverse reaction of tPA administration - angioedema. After CT and laboratory findings, our patient received cryoprecipitate for tPA reversal. Our case highlights a unique case of RPH mimicking angioedema following tPA administration.

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- Allison Jolley, Madison McKnight, and Kacie Clark.
- Department of Pharmacy, Methodist University Hospital, 1265 Union Avenue, Memphis, TN 38104, United States of America; Department of Clinical Pharmacy and Translational Science, University of Tennessee Health Sciences College of Pharmacy, 881 Madison Avenue, Memphis, TN 38163, United States of America.
- Am J Emerg Med. 2023 May 1; 67: 196.e1196.e2196.e1-196.e2.
AbstractTissue plasminogen activator (tPA) is a cornerstone treatment for acute ischemic stroke (AIS). Administration of tPA is not without risk, and can provoke life threatening adverse reactions. Retropharyngeal hematoma (RPH) following tPA administration has only been reported after tenecteplase (TNK) administration for ST elevation myocardial infarction (STEMI). A 78 year old patient received tPA for AIS. Following administration of tPA, this patient developed acute signs and symptoms of what appeared to be a more well-known adverse reaction of tPA administration - angioedema. After CT and laboratory findings, our patient received cryoprecipitate for tPA reversal. Our case highlights a unique case of RPH mimicking angioedema following tPA administration.Copyright © 2023 Elsevier Inc. All rights reserved.

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Retropharyngeal hematoma mimicking angioedema after intravenous thrombolysis for acute ischemic stroke.

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