SIMULTANEOUS BILATERAL THALAMIC HEMORRHAGES FOLLOWING THE ADMINISTRATION OF INTRAVENOUS TISSUE-PLASMINOGEN ACTIVATOR

A patient suffered the onset of simultaneous bilateral thalamic hemorr hage several hours after the administration of intravenous tissue plas minogen activator. The patient exhibited features of the paramedian di encephalic syndrome, including executive dysfunction, anterograde amne sia, inattention, and disturbances of visual perception. During rehabi litation, she made significant gains in overlearned activities of dail y living tasks, but her inability to retain new information left her s everely disabled. The use of intravenous thrombolytic therapy is belie ved to account for this patient's unusual stroke syndrome. With recent evidence supporting the efficacy of intravenous thrombolysis in acute stroke, patients with multiple hemorrhagic strokes as a result of thr ombolysis may become more common on rehabilitation services. (C) 1997 by the American Congress of Rehabilitation Medicine and the American A cademy of Physical Medicine and Rehabilitation