|1. Consider bleeding the likely cause of
neurologic worsening after use of a thrombolytic
drug until a brain scan confirms or refutes
|2. Immediately discontinue ongoing infusion
of thrombolytic drug.
|3. Obtain emergent head CT or MRI stat.
|4. Obtain blood samples for type and
crossmatch, prothrombin time, activated partial
thromboplastin time, platelet count, and
|5. If intracerebral
hemorrhage is confirmed by imaging:
|Give 10 units of
cryoprecipitate to increase the levels of
fibrinogen and factor VIII
|Give 6 to 8 units of
|In patients receiving
unfractionated heparin (UFH) for any reason,
consider giving 1 mg of protamine for every 100
U of UFH received in the preceding four hours.
|6. Obtain neurosurgical consultation and
consider evacuation of the hematoma.