Topic Teaching: Intracranial hemorrhage post systemic thrombolysis in ischemic stroke patients - A focus on fibrinogen repletion


Event details

Presented by:

Dr. Isabelle Blais-Normandin
Transfusion Medicine Physician Trainee
University of British Columbia


1.    Explain the pathophysiology associated with bleeding post rt-PA.
2.    List the advantages and disadvantages of using fibrinogen concentrate or cryoprecipitate.
3.    Prescribe the initial treatment of an intracranial hemorrhage post-rt-PA.


1.    Barra M, Feske S, Sylvester K and al. Fibrinogen concentrate for the treatment of thrombolysis-associated hemorrhage in adult ischemic stroke. Clinical and applied Thrombosis / Hemostasis. 2020: 20 ; 1-9
2.    Franchini M, Lippi G. Fibrinogen replacement therapy: a critical review of the literature. Blood Transf. 2012: 10 ; 23-27
3.    Yaghi S, Willey J, Cucchiara B and al. Treatment and outcome of hemorrhagic transformation after intravenous alteplase in acute ischemic stroke- A scientific statement for healthcare professionals from the American Heart Association and American stroke association. Stroke. 2017: 48;343-361
4.    Callum J, Farkouh M, Scales D and al. Effect of fibrinogen concentrate vs cryoprecipitate on blood component transfusion after cardiac surgery- The FIBRES randomized clinical trial. JAMA. 2019: 322(20); 1966-1976


Note: The session is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification program of The Royal College of Physicians and Surgeons of Canada.

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The LearnTransfusion series is the seminar component of the Areas of Focused Competency (AFC)-Diploma Program in Transfusion Medicine. The series, organized by Canadian Blood Services is also open to all practitioners in the field of Transfusion Medicine. Through a series of regular webinars, trainees and practitioners are exposed to various scientific, technical and clinical aspects of transfusion medicine.