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Updated: Jan 23, 2026
05:52
Prehospital Thrombolysis: A Manual from Berlin
Published on: November 26, 2013
22.3K
Angioedema in Stroke Patients With Thrombolysis
Kilian Fröhlich1, Kosmas Macha1, Stefan T Gerner1
1From the Department of Neurology (K.F., K.M., S.T.G., T.B., M.J.H., S.S., F.S., B.K., K.W.), University Hospital Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Germany.
Stroke
|June 12, 2019
Summary
Oral angioedema (OA) after thrombolysis for ischemic stroke is linked to right insulo-opercular lesions. Lower blood pressure in these patients may indicate bradykinin effects.
Area of Science:
- Neurology
- Vascular Neurology
- Stroke Medicine
Background:
- Oral angioedema (OA) is a rare, life-threatening complication following intravenous thrombolysis for ischemic stroke.
- Recombinant tissue-type plasminogen activator (r-tPA) is a common thrombolytic agent used in stroke treatment.
Purpose of the Study:
- To investigate the association between thrombolysis-related OA and specific ischemic stroke lesion locations.
- To utilize voxel-wise lesion analysis for precise localization of stroke-related brain damage.
Main Methods:
- Prospective registry data from 2002-2018 identified patients with thrombolysis-related OA.
- A control group of ischemic stroke patients without OA receiving thrombolysis was included.
- Ischemic lesions were manually delineated on MRI/CT scans, transformed into stereotaxic space, and analyzed voxel-wise using the Liebermeister test.
Main Results:
- Fifteen patients with thrombolysis-related OA were identified.
- Voxel-wise analysis revealed a significant association between OA and lesions in the right insulo-opercular region.
- Patients with OA exhibited significantly lower mean blood pressure compared to controls.
Conclusions:
- Thrombolysis-related OA in ischemic stroke is associated with lesions in the right insulo-opercular cortex.
- Lower blood pressure in OA patients may be attributed to bradykinin-induced vasodilation and increased vascular permeability.
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