Related Experiment Video
Updated: Jul 20, 2026

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
Published on: August 18, 2015
Paradoxically accelerated fatal brain herniation following thrombolytic therapy in acute ischemic stroke
Sang Won Han1, Seo Hyun Kim, Ha Young Shin
1Department of Neurology, National Core Research Center for Nanomedical Technology, Brain Korea 21 Project for Medical Sciences, Yonsei University College of Medicine, Seodaemoon-ku, Seoul, Korea.
Introduction:
The use of plasminogen activators (PAs) in acute stroke patients has dual effects. PAs are beneficial by dissolving thrombi occluding an artery, but may be harmful by their proteolytic and excitotoxic actions.
Methods And Results:
We report two patients with a fatal brain herniation who rapidly deteriorated despite the successful recanalization and the sustained arterial patency or blood flow. Imaging studies taken after the thrombolytic treatment suggested early occurrence of cellular damage and profound breakdown of the blood-brain barrier.
Conclusion:
Fatal brain edema occurred after persistent reperfusion by the thrombolytic therapy. Paradoxical thrombolytic-induced injury, which has been suggested in experimental studies, might play a role.
Related Concept Videos
Ischemic Stroke ll: Pathophysiology
Hemorrhagic Stroke ll: Pathophysiology
Transient Ischemic Attack l: Introduction
Ischemic Stroke l: Introduction
Hemorrhagic Stroke l: Introduction
Venous Thrombosis III: Interprofessional Care

