A Case of Cerebral Hemorrhage and Critical Platelet Count After Intravenous Thrombolysis and Bridging Thrombectomy
Abstract：Objective To explore the causes of platelet reduction and cerebral hemorrhage after intravenous thrombolysis and bridging thrombectomy in acute ischemic stroke. Methods A retrospective summary of the treatment process of a patient with acute cerebral infarction was conducted. The patient received alteplase intravenous thrombolysis and bridging thrombectomy after excluding contraindications. Combined with literature analysis, the causes of critical platelet count and intracranial hemorrhage were discussed. Results Heparin anticoagulation was used during the operation, and tirofiban antiplatelet therapy was administered. Postoperative head CT within 30 minutes showed intracranial hemorrhage. Blood routine examination revealed a critical platelet count. Cold precipitate and plasma were administered for symptomatic rescue, but the effect was poor. The patient developed cerebral herniation, and the family refused further treatment. Conclusion The critical platelet count is considered to be drug-related. The use of tirofiban during the operation may be the reason for the sharp decrease in platelets. The abnormal coagulation function after severe platelet reduction and surgical factors may be the cause of bleeding.
Keywords：Ischemic StrokeCerebral HemorrhageIntravenous ThrombolysisThrombectomyCritical Platelet Count
Publication Date：2025-08-20
Online Publishing Date：2025-08-29(First online date of this platform, not the publication date of the document)
Pages：3( 486-488 )