Angioedema in Stroke Patients With Thrombolysis

Beitrag in einer Fachzeitschrift

Details zur Publikation

Autorinnen und Autoren: Fröhlich KM, Macha K, Gerner S, Bobinger T, Schmidt M, Dörfler A, Hilz MJ, Schwab S, Seifert F, Kallmünzer B, Winder K
Zeitschrift: Stroke
Jahr der Veröffentlichung: 2019
Band: 50
Heftnummer: 7
Seitenbereich: 1682-1687
ISSN: 1524-4628


Background and Purpose- Oral angioedema (OA) is a rare but life-threatening complication in patients with ischemic stroke receiving intravenous thrombolysis with r-tPA (recombinant tissue-type plasminogen activator). This study intended to determine associations between thrombolysis-related OA and ischemic stroke lesion sites using a voxel-wise lesion analysis. Methods- Prospective registry data were used to identify ischemic stroke patients with thrombolysis-related OA between 2002 and 2018. For the study registry, ethics approval was obtained by the Ethics Committee of the Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg (clinical registry registration: 377_17Bc). Ischemic stroke patients with thrombolysis treatment but without OA admitted in the years 2011 and 2012 comprised the control group. Ischemic lesions were manually outlined on magnetic resonance imaging (1.5T or 3T) or computed tomographic scans and transformed into stereotaxic space. We determined the lesion overlap and compared the absence or presence of OA voxel-wise between patients with and without lesions in a given voxel using the Liebermeister test. Stroke severity was rated using the National Institutes of Health Stroke Scale score, and blood pressure, heart rate, blood glucose levels, and body temperature were determined on admission. Results- Fifteen ischemic stroke patients with thrombolysis-related OA were identified. The voxel-wise analysis yielded associations between OA and ischemic lesions in the insulo-opercular region with a right hemispheric dominance. Mean blood pressure was significantly lower in patients with OA than in controls. Age, National Institutes of Health Stroke Scale scores, infarct volumes, heart rate, and blood glucose levels did not differ between patients with and without OA. Conclusions- The voxel-wise analysis linked thrombolysis-related OA to right insulo-opercular lesions. The lower blood pressure in patients with thrombolysis-related OA may reflect bradykinin effects causing vasodilatation and increasing vascular permeability.

FAU-Autorinnen und Autoren / FAU-Herausgeberinnen und Herausgeber

Dörfler, Arnd Prof. Dr.
Fröhlich, Katharina Maria
Neuroradiologische Abteilung im Radiologischen Institut
Medizinische Fakultät
Gerner, Stefan
Medizinische Fakultät
Hilz, Max-Josef Prof. Dr. med.
Professur für Neurologie
Kallmünzer, Bernd PD Dr.
Neurologische Klinik
Macha, Kosmas
Medizinische Fakultät
Schmidt, Manuel Dr. med.
Neuroradiologische Abteilung im Radiologischen Institut
Schwab, Stefan Prof. Dr.
Lehrstuhl für Neurologie
Seifert, Frank Prof. Dr.
Medizinische Fakultät


Fröhlich, K.M., Macha, K., Gerner, S., Bobinger, T., Schmidt, M., Dörfler, A.,... Winder, K. (2019). Angioedema in Stroke Patients With Thrombolysis. Stroke, 50(7), 1682-1687.

Fröhlich, Katharina Maria, et al. "Angioedema in Stroke Patients With Thrombolysis." Stroke 50.7 (2019): 1682-1687.


Zuletzt aktualisiert 2019-26-07 um 09:34