A Swollen Surprise After Stroke Care

A 78-year-old man receives t-PA for an ischemic Stroke but develops an unexpected and alarming orolingual swelling. Explore this rare adverse effect.

Tissue plasminogen activator-associated angioedema


A 78-year-old man presented to the emergency department with weakness on the left side that had developed 90 minutes earlier. An ischemic stroke in the territory of the right middle cerebral artery was diagnosed, and treatment was initiated. After some time, examination showed the following change in the patient’s tongue. What is the most likely diagnosis?

What is the most likely diagnosis?

Tissue plasminogen activator-associated angioedema
Lingual artery thrombosis
Lingual dystonia
Unilateral hypoglossal nerve palsy
Melkersson-Rosenthal syndrome

Angioedema, Ischemic Stroke, t-PA, Thrombolysis, Tissue plasminogen activator-associated angioedema

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