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A cranial CT was carried out, aimed at signs of hyper acute ischaemia in the territory of the left middle cerebral artery (MCA). With the diagnosis of ischaemic stroke, revascularisation treatment with intravenous recombinant tissue-type plasminogen activator (RTPA) was begun. One hour after the administration of RTPA, the patient developed right hemifacial oedema (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). Suspecting angioneurotic oedema, treatment with antihystemines and intravenous methylprednisolone was initiated. The situation was completely resolved in 24<span class="elsevierStyleHsp" style=""></span>h. In the control CT, an ischaemic lesion was observed in the territory of the left MCA (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B, asterisks).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Angioneurotic oedema appears in around 2% of patients treated with RTPA, and is most frequent in patients undergoing treatment with angiotensin converting enzyme inhibitors. The pathophysiology of the latter has not been clarified, although it appears that it could be related to the increase in serum levels of bradykinin. Typically, it appears on the contralateral side of the affected cerebral hemisphere as a slight and transitory complication, although in serious cases it could require urgent management of the airway.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: López-Delgado L, López-Fernández JC. Edema angioneurótico tras trombólisis intravenosa. Med Clin (Barc). 2017;148:e65.</p>" ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1380 "Ancho" => 3000 "Tamanyo" => 370250 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000014800000011/v1_201706250038/S2387020617303418/v1_201706250038/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000014800000011/v1_201706250038/S2387020617303418/v1_201706250038/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020617303418?idApp=UINPBA00004N" ]
Journal Information
Vol. 148. Issue 11.
Pages e65 (June 2017)
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Vol. 148. Issue 11.
Pages e65 (June 2017)
Image in medicine
Orolingual angioedema after thrombolytic treatment
Edema angioneurótico tras trombólisis intravenosa
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