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Neurological picture
Orolingual angio-oedema after alteplase therapy in a stroke patient concurrently using angiotensin II receptor blocker
  1. Chun-Hsiang Tan,
  2. Sung-Chun Tang,
  3. Ru-Jen Lin,
  4. Jiann-Shing Jeng
  1. Stroke Centre and Department of Neurology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
  1. Correspondence to Dr Jiann-Shing Jeng, Department of Neurology, National Taiwan University Hospital, No 7 Chung-Shan South Road, Taipei 100, Taiwan; jsjeng{at}ntu.edu.tw

https://doi.org/10.1136/jnnp.2009.194878

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    An 82-year-old female with history of hypertension, atrial fibrillation and rectosigmoid cancer status postoperation without recurrence had a sudden onset of right hemiparesis and aphasia. She had regularly taken irbesartan, atenolol, propafenone and indapamide. On arrival at the emergency room, she was globally aphasic and had right hemiparesis, hemihypoaesthesia and homonymous hemianopia. Her initial National Institutes of Health Stroke Scale Score was 20. Head CT 65 min after onset of symptoms showed a left hyperdense middle cerebral artery sign. A left middle cerebral artery infarction was diagnosed. She received recombinant tissue plasminogen activator (rt-PA) (alteplase, 0.75 mg/kg) 140 min after onset of …

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    Footnotes

    • Competing interests None.

    • Patient consent Obtained.

    • Ethics approval Ethics approval was provided by the Ethics Committee of National Taiwan University Hospital.

    • Provenance and peer review Not commissioned; externally peer reviewed.