Postthrombolysis Intracranial 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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