Thrombolysis for concomitant acute stroke and pulmonary embolism

We report our management of a patient presenting with concomitant cortical stroke and pulmonary embolism. Stroke symptoms and respiratory distress were present for 2 h at the time of initial assessment. The patient was treated with intravenous tissue plasminogen activator (tPA). Intravenous unfractionated heparin was given 24 h after treatment with tPA. The patient’s neurological and respiratory status both improved following thrombolysis. The treatment options and potential dilemmas are discussed.