In this episode, Sam Ashoo, MD and Dr. Syeda Maria Muzammil, MD discuss the August 2026 Emergency Medicine Practice article, Emergency Department Management of Postthrombolysis Intracranial Hemorrhage.

0:25 – Intro & sponsor message
1:18 – Guest introduction: Dr. Maria Muzammil
2:24 – Timeframe for post-thrombolysis hemorrhage & ED/ICU boarding considerations
4:46 – Thrombolysis eligibility criteria & contraindications
5:46 – Incidence rates & symptomatic vs. asymptomatic hemorrhage
7:09 – Pathophysiology & risk factors for post-thrombolytic ICH
10:18 – Combining IV thrombolysis with endovascular thrombectomy
12:33 – Post-treatment monitoring protocols & neurological exam frequency
15:02 – Differentiating hemorrhage from other causes of neurological decline
18:34 – Initial ED steps
20:35 – Heidelberg classification of hemorrhage types
21:60 – Follow-up imaging
25:27 – Treatment of confirmed hemorrhage
30:10 – Platelet transfusion guidance
32:39 – Delayed hemorrhage & treatment timing considerations
34:21 – Blood pressure management goals post-hemorrhage
37:20 – Special populations
38:48 – Summary of ED management algorithm
40:48 – Closing remarks

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Postthrombolysis Intracranal Hemorrhage

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