Spinal subdural hematoma as a complication of tenecteplase treatment for acute ischemic stroke: A case report

Intravenous thrombolysis is an effective treatment for acute ischemic stroke. The ESO recommends that tenecteplase be used for thrombolytic therapy in stroke within 4.5h of onset. However, there are few reports on the complications of intravenous thrombolysis with tenecteplase in stroke, and spinal hematomas are rare. Herein, we report the first case of spinal subdural hematoma secondary to tenecteplase treatment for stroke. A 71-year-old male patient arrived at the stroke center because of left limb weakness that had persisted for 105 min. After intravenous thrombolysis with tenecteplase, the patient experienced unbearable pain in the neck and left shoulder, progressive limb weakness, and sensory disturbance. MRI revealed a spinal subdural hematoma of the cervical vertebrae, and the prognosis was poor after surgical treatment. Once patients develop pain around the spine with intravenous thrombolysis, physicians should be aware of the possibility of a spinal subdural hematoma and promptly perform MRI.