{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:42:09Z","timestamp":1792269729741,"version":"4.4.0"},"reference-count":12,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Symptomatic intracerebral hemorrhage is a feared complication of intravenous thrombolysis for acute ischemic stroke and is typically associated with hematoma expansion and poor clinical outcomes. The management of such hematomas represents a significant neurosurgical challenge, particularly in the setting of thrombolysis-induced hypocoagulability. Rapid spontaneous regression of large intracerebral hematomas remains an exceptionally rare phenomenon.<\/jats:p>\n <\/jats:sec>\n \n Case Description:<\/jats:title>\n We report the case of a 57-year-old woman who presented with an acute ischemic stroke due to left middle cerebral artery occlusion. Following intravenous thrombolysis with tenecteplase, the patient experienced neurological deterioration, and imaging revealed a massive left intra-parenchymal hematoma associated with significant mass effect and herniation. Despite the severity of the initial presentation, follow-up imaging performed 24 h later demonstrated a marked spontaneous reduction in hematoma volume, with substantial improvement in mass effect and complete resolution of uncal herniation.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n This case highlights an unusual evolution of post-thrombolysis intracerebral hemorrhage and suggests that, in acute hypocoagulable states, hematoma dynamics may differ from the classical course. Potential mechanisms include early redistribution of blood and impaired clot stabilization. These findings, in line with recent observations in similar contexts, may have implications for understanding hematoma evolution and guiding clinical decision-making.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_539_2026","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:12:41Z","timestamp":1787922761000},"page":"490","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Rapid spontaneous regression of a massive post-thrombolysis intracerebral hemorrhage: A case report"],"prefix":"10.25259","volume":"17","author":[{"given":"Mehdi","family":"Mdarhri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamza","family":"Sriri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oualid Mohammed","family":"Hmamouche","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marouane","family":"Hammoud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faycal","family":"Lakhdar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Benzagmout","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Chakour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed El","family":"Faiz Chaoui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"10.25259\/SNI_539_2026\/ref-1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/02688697.2026.2627278","article-title":"Spontaneous ultra-early resorption of an intracerebral hematoma in a cirrhotic patient: Case report and analysis of this unusual phenomenon","author":"Agresta","year":"2026","journal-title":"Br J Neurosurg"},{"key":"10.25259\/SNI_539_2026\/ref-2","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1186\/s13054-020-2749-2","article-title":"Surgery for spontaneous intracerebral hemorrhage","volume":"24","author":"De Oliveira Manoel","year":"2020","journal-title":"Crit Care"},{"key":"10.25259\/SNI_539_2026\/ref-3","doi-asserted-by":"crossref","first-page":"273","DOI":"10.13004\/kjnt.2020.16.e44","article-title":"A case of rapid spontaneous disappearance of traumatic intraventricular hemorrhage","volume":"16","author":"Eom","year":"2020","journal-title":"Korean J Neurotrauma"},{"key":"10.25259\/SNI_539_2026\/ref-4","doi-asserted-by":"crossref","first-page":"96","DOI":"10.3340\/jkns.2009.45.2.96","article-title":"Rapid spontaneous redistribution of acute epidural hematoma : Case report and literature review","volume":"45","author":"Eom","year":"2009","journal-title":"J Korean Neurosurg Soc"},{"key":"10.25259\/SNI_539_2026\/ref-5","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1159\/000475532","article-title":"Disappearance of the hemorrhagic component of the frontal contusion possibly due to redistribution of the hematoma within the subarachnoid space: A case report","volume":"52","author":"Faheem","year":"2017","journal-title":"Pediatr Neurosurg"},{"key":"10.25259\/SNI_539_2026\/ref-6","doi-asserted-by":"crossref","first-page":"e282","DOI":"10.1161\/STR.0000000000000407","article-title":"Guideline for the management of patients with spontaneous intracerebral hemorrhage: A guideline from the American heart association\/American stroke association","volume":"53","author":"Greenberg","year":"2022","journal-title":"Stroke"},{"key":"10.25259\/SNI_539_2026\/ref-7","doi-asserted-by":"crossref","first-page":"104","DOI":"10.7461\/jcen.2012.14.2.104","article-title":"Rapid spontaneous reduction of a huge intracerebral hematoma","volume":"14","author":"Han","year":"2012","journal-title":"J Cerebrovasc Endovasc Neurosurg"},{"key":"10.25259\/SNI_539_2026\/ref-8","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/S0973-0508(05)80011-5","article-title":"Spontaneous rapid resolution of traumatic subarachnoid hemorrhage","volume":"02","author":"Kurve","year":"2005","journal-title":"Indian J Neurotrauma"},{"key":"10.25259\/SNI_539_2026\/ref-9","first-page":"614","article-title":"Blood Clot resolution in human cerebrospinal fluid: Evidence of first-order kinetics","volume":"49","author":"Naff","year":"2001","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_539_2026\/ref-10","first-page":"573","article-title":"Rapid absorption of a spontaneous primary intraventricular hemorrhage","volume":"18","author":"Shi","year":"2025","journal-title":"Int Med Case Rep J"},{"key":"10.25259\/SNI_539_2026\/ref-11","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1001\/jamaneurol.2014.1210","article-title":"Symptomatic intracerebral hemorrhage in acute ischemic stroke after thrombolysis with intravenous recombinant tissue plasminogen activator: A review of natural history and treatment","volume":"71","author":"Yaghi","year":"2014","journal-title":"JAMA Neurol"},{"key":"10.25259\/SNI_539_2026\/ref-12","doi-asserted-by":"crossref","first-page":"390","DOI":"10.2176\/nmc.50.390","article-title":"Rapid spontaneous resolution of neurological signs and cerebral herniation caused by intracerebral hemorrhage-case 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