Airway compromise secondary to lingual hematoma complicating administration of tissue plasminogen activator for acute ischemic stroke

Hemorrhagic complications of tissue plasminogen activator (tPA) are well kn own. We report a case of a lingual hematoma that developed after tPA admini stration for an acute ischemic stroke that necessitated orotracheal intubat ion to maintain the patient's airway. This case demonstrates the need for t horough preadministration physical examination, as well as careful monitori ng during infusion and after administration of this potent therapeutic agen t.