Tissue plasminogen activator-associated lingual artery hemorrhage

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

Hemorrhagic complications of tissue plasminogen activator (tPA) are well known. We report a case of a lingual hematoma that developed after tPA administration for an acute ischemic stroke that necessitated orotracheal intubation to maintain the patient's airway. This case demonstrates the need for thorough preadministration physical examination, as well as careful monitoring during infusion and after administration of this potent therapeutic agent.

Lingual artery hematoma resulting in upper airway obstruction

A case of upper airway obstruction from a lingual artery hematoma after suturing of a puncture wound to the tongue is reported. The anatomy of the tongue and upper airway is reviewed to better understand the mechanism of obstruction. The emergency physician should be aware of this rare and potentially lethal complication to what might initially seem to be a trivial injury.