Airway compromise secondary to lingual hematoma complicating administration of tissue plasminogen activator for acute ischemic stroke

Life–threatening orolingual angioedema during thrombolysis in acute ischemic stroke

“…However, imaging data were missing in this report [7]. To our knowledge, this is the first report of CT findings of the tongue, which excluded lingual hematoma and confirmed angioedema as underlying pathology for the clinically observed lingual swelling in alteplase-treated stroke patients.…”

Critical Hemorrhage in the Floor of the Mouth During Implant Placement in the First Mandibular Premolar Position: A Case Report

“…3,7 Treatment of acute ischemic cerebrovascular episodes and myocardial infarctions with tissue plasminogen activator, aspirin, heparin, or streptokinase has occasionally induced lingual, sublingual, and submandibular hematomas with subsequent airway deterioration. [8][9][10] In addition, chronic prophylactic administration of heparin and warfarin has also precipitated similar spontaneous and metatraumatic life-endangering incidents. [11][12][13] Massive lingual/sublingual hemorrhage and following airway emergencies have been reported in gunshot wounds through the lower face, 14 home accidents, 15 and blunt trauma of the head caused by traffic collisions.…”

Lingual hematoma threatening airway obstruction in a patient on oral anticoagulation with warfarin

“…Extensive hemorrhage from the lingual artery may occur following traumatic injury [4][5][6][7]. Hemorrhage into the tongue has been reported after the use of streptokinase, heparin, tissue-type plasminogen activator administration and in hemophilia [6,[8][9][10]. Sublingual hematomas leading to upper airway obstruction have also been reported in patients treated with anticoagulants [2,11].…”

“…In most of the cases managed with observation, rapid deterioration of the airway occurred. According to the clinical situation, orotracheal intubation, nasotracheal intubation, cricothyrotomy or tracheostomy was chosen for airway management [2][3][4][5][6][7][8][9][10].…”