AUTHOR=Lin Jie , Weng Xiongpeng , Zheng Jing , Wu Saizhen , Bao Qiongqiong , Peng Feifei , Huang Yanbin 

TITLE=Case report: Thrombolysis in patients with acute ischemic stroke and cerebral cavernous malformation

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1281412

DOI=10.3389/fneur.2023.1281412

ISSN=1664-2295

ABSTRACT=Background: Cerebral cavernous malformation (CCM) is a rare disease associated with a latent risk of intracranial hemorrhage. However, due to limited evidence, the safety of recommending intravenous tissue plasminogen activator for patients with acute stroke and CCM remains uncertain.
Methods: Our study identified five patients with acute stroke and CCM treated between 2017 and 2023 across two hospitals. A comprehensive literature review was conducted, incorporating three similar case reports and two retrospective studies.
Results: Among 30 patients reviewed, three exhibited symptomatic intracranial hemorrhage, two of whom were female. Additionally, three patients presented with calcification in their CCM, with two experiencing symptomatic intracranial hemorrhage.
Conclusions: The observed incidence of symptomatic intracranial hemorrhage following intravenous tissue plasminogen activator administration appears to be elevated in patients with CCM. Therefore, before thrombolysis, a thorough evaluation of personalized risk-benefit ratios is crucial. Furthermore, conducting further research involving multiple centers and larger sample sizes is imperative to advance our understanding in this area, especially, identifying hemorrhage risk factors.