Postthrombolysis Intracranal Hemorrhage

In this episode, Sam Ashoo, MD and Dr. Syeda Maria Muzammil, MD discuss the August 2026 Emergency Medicine Practice article, Emergency Department Management of Postthrombolysis Intracranial Hemorrhage.

• 0:25 – Intro & sponsor message
• 1:18 – Guest introduction: Dr. Maria Muzammil
• 2:24 – Timeframe for post-thrombolysis hemorrhage & ED/ICU boarding considerations
• 4:46 – Thrombolysis eligibility criteria & contraindications
• 5:46 – Incidence rates & symptomatic vs. asymptomatic hemorrhage
• 7:09 – Pathophysiology & risk factors for post-thrombolytic ICH
• 10:18 – Combining IV thrombolysis with endovascular thrombectomy
• 12:33 – Post-treatment monitoring protocols & neurological exam frequency
• 15:02 – Differentiating hemorrhage from other causes of neurological decline
• 18:34 – Initial ED steps
• 20:35 – Heidelberg classification of hemorrhage types
• 21:60 – Follow-up imaging
• 25:27 – Treatment of confirmed hemorrhage
• 30:10 – Platelet transfusion guidance
• 32:39 – Delayed hemorrhage & treatment timing considerations
• 34:21 – Blood pressure management goals post-hemorrhage
• 37:20 – Special populations
• 38:48 – Summary of ED management algorithm
• 40:48 – Closing remarks

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