Principal dx. = 434.91, (Cerebral artery occlusion, unspecified, with cerebral infarction), . +
997.02, (Iatrogenic cerebrovascular infarction or hemorrhage), +
431,(Intracerebral hemorrhage), for the cerebral hemorrhagic conversion due to the thrombolytic tx. (997.02 is assigned b/c the hemorrhage resulted from tx. with the thrombolytic) Also assign:
784.3, Aphasia, +
E934.4, Drugs, adverse effects +
99.10, Injection or infusion of thrombolytic agent.
Pt. admitted with expressive aphasia due to acute cerebral infarction. The patient was given intravenous (IV) tissue plasminogen activator (tPA) within 4.5 hours of the onset of symptoms, with significant improvement of aphasia. A brain MRI showed acute left temporoparietal infarct with asymptomatic hemorrhagic conversion. The provider stated that the hemorrhagic conversion was caused by the tPA therapy.