Stroke Research Today is a free monthly online journal that collates and summarizes the latest research about Stroke, including details on treatment, recovery, rehabilitation, signs, symptoms.

Multiple ischemic strokes associated with use of recombinant activated factor VII.

Libman RB, Lungu C, Kwiatkowski T

Department of Neurology, Long Island Jewish Medical Center, New Hyde Park, NY 11040, USA. rlibman@lij.edu

BACKGROUND: Intracerebral hemorrhage is associated with a high rate of mortality and functional disability. For most patients, no treatment other than supportive care has been shown to improve outcome. Preliminary studies suggest that recombinant activated factor VII may limit early hematoma growth and improve functional outcome. However, ischemic complications may occur in some patients. OBJECTIVE: To report a case of severe cerebral ischemic complications associated with the use of recombinant activated factor VII. DESIGN: Case report. SETTING: Tertiary care medical center. PATIENT: We describe a patient with ischemic stroke who developed hemorrhagic conversion following tissue plasminogen activator administration. INTERVENTIONS: Treatment with recombinant activated factor VII, in addition to standard treatment with cryoprecipitate and platelets. MAIN OUTCOME MEASURE: Brain imaging showing multiple ischemic strokes. RESULTS: The patient subsequently developed multiple acute cerebral infarcts in different vascular distributions. CONCLUSION: Although the exact relationship between treatment with recombinant activated factor VII and the development of multiple ischemic strokes remains uncertain, this case suggests that a cautious approach to treatment with this agent is warranted until more data are available.

Published 12 June 2007 in Arch Neurol, 64(6): 879-81.
Full-text of this article is available online (may require subscription).

© 2004-2008 Stroke Research Today. All Rights Reserved.