ReviewJAMA neurology2014
Symptomatic intracerebral hemorrhage in acute ischemic stroke after thrombolysis with intravenous recombinant tissue plasminogen activator: a review of natural history and treatment.
Review in JAMA neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
80 citing papers in PubMed, 4 syntheses or guidelines pooled it, 183 citations in OpenAlex.
- Safety Outcomes Following Intravenous Thrombolysis in Acute Ischemic Stroke: A Systematic Review and Network Meta-analysis.CNS drugs · 2026Pooled it
- Safety and efficacy of intravenous thrombolysis: a systematic review and meta-analysis of 93,057 minor stroke patients.BMC neurology · 2025Pooled it
- Efficacy and safety of endovascular treatment with or without intravenous alteplase in acute anterior circulation large vessel occlusion stroke: a meta-analysis of randomized controlled trials.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2022Pooled it
- Endovascular Treatment With and Without Intravenous Thrombolysis in Large Vessel Occlusions Stroke: A Systematic Review and Meta-Analysis.Frontiers in neurology · 2021Pooled it
- Effectiveness and safety of bridging therapy and endovascular therapy in patients with large cerebral infarctions: from ANGEL-ASPECT.Stroke and vascular neurology · 2025Trial
- Safety and efficacy of low-dose rt-PA with tirofiban to treat acute non-cardiogenic stroke: a single-center randomized controlled study.BMC neurology · 2022Trial
- Trial
- CD8+ regulatory T cells shorten neutrophil lifespan to reduce hemorrhagic transformation after ischemic stroke.The Journal of clinical investigation · 2026Article
- Rapid spontaneous regression of a massive post-thrombolysis intracerebral hemorrhage: A case report.Surgical neurology international · 2026Article
- Early Anticoagulation After Large Ischemic Stroke in the Initiation of Anticoagulation After Cardioembolic Stroke Study.Journal of clinical neurology (Seoul, Korea) · 2025Article
- Efficacy and safety of bridging intravenous thrombolysis before mechanical thrombectomy in acute ischemic stroke: A systematic review and meta-analysis.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
- ETRAISI registry report: clinical characteristics and related factors of outcome in reperfusion-eligible AIS patients.BMC neurology · 2025Article
- Improving "No-Reflow" After Complete Reperfusion: The Role of Intravenous Thrombolysis in Vertebrobasilar Artery Occlusion Patients Undergoing Endovascular Treatment.Journal of the American Heart Association · 2025Article
- Hemorrhagic transformation in acute ischemic stroke: hemorrhagic subtypes and symptomatic intracranial hemorrhage.Journal of neurointerventional surgery · 2025Observational
- Outcomes and risk factors for functional prognosis at 3 months after intravenous thrombolysis with r-tPA in patients with acute ischemic stroke: a retrospective cohort study.Thrombosis journal · 2025Article
- Protofibril packing density of individual fibers alters fibrinolysis.Research and practice in thrombosis and haemostasis · 2025Article
- Deep learning of noncontrast CT for fast prediction of hemorrhagic transformation of acute ischemic stroke: a multicenter study.European radiology experimental · 2025Article
- Evaluating predictive models for hemorrhagic transformation post-mechanical thrombectomy in acute ischemic stroke.Frontiers in neurology · 2025Review
- Utilizing prior-data-fitted networks and in-context learning: a transformer-based tabular foundation model for predicting symptomatic intracranial hemorrhage after successful recanalization.Frontiers in neurology · 2025Article
- Intravenous thrombolysis and mechanical thrombectomy in acute stroke patients on direct oral anticoagulants.Journal of neurology · 2024Review
20 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
importanceIntravenous thrombolysis remains the mainstay treatment for acute ischemic stroke. One of the most feared complications of the treatment is thrombolysis-related symptomatic intracerebral hemorrhage (sICH), which occurs in nearly 6% of patients and carries close to 50% mortality. The treatment options for sICH are based on small case series and expert opinion, and the efficacy of recommended treatments is not well known.
objectiveTo provide an overview on the rationale and mechanism of action of potential treatments for sICH that may reverse the coagulopathy before hematoma expansion occurs. EVIDENCE REVIEW: Evidence-based peer-reviewed articles, including randomized trials, case series and reports, and retrospective reviews, were identified in a PubMed search on the mechanism of action of intravenous recombinant tissue plasminogen activator and the rationale of various potential treatments using the coagulation cascade as a model. The search encompassed articles published from January 1, 1990, through February 28, 2014.
findingsThe current treatments may not be sufficient to reverse coagulopathy early enough to prevent hematoma expansion and improve the outcome of thrombolysis-related hemorrhage. CONCLUSIONS AND RELEVANCE: Given the mechanism of action of intravenous recombinant tissue plasminogen activator, clinical studies could include agents with a fast onset of action, such as prothrombin complex concentrate, recombinant factor VIIa, and ε-aminocaproic acid, as potential therapeutic options.
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Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.