Successful intravenous thrombolysis of a wake-up stroke with underlying valvular atrial fibrillation
A 42-year-old female admitted with new-onset atrial fibrillation had a wake-up stroke on the high-dependency unit and the time last seen well (TLSW) was 6.5 h. She suffered left-sided body weakness and her National Institutes of Health Stroke Scale (NIHSS) score was 17. An emergency CT perfusion sho...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English English English |
| Published: |
Royal College of Physicians of Edinburgh
2018
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/70141/ http://irep.iium.edu.my/70141/ http://irep.iium.edu.my/70141/ http://irep.iium.edu.my/70141/1/70141_Successful%20intravenous%20thrombolysis.pdf http://irep.iium.edu.my/70141/2/70141_Successful%20intravenous%20thrombolysis_SCOPUS.pdf http://irep.iium.edu.my/70141/3/70141_Successful%20intravenous%20thrombolysis_WOS.pdf |
| Summary: | A 42-year-old female admitted with new-onset atrial fibrillation had a wake-up stroke on the high-dependency unit and the time last seen well (TLSW) was 6.5 h. She suffered left-sided body weakness and her National Institutes of Health Stroke Scale (NIHSS) score was 17. An emergency CT perfusion showed right M1 segment occlusion with more than 50% penumbra. She was given recombinant tissue plasminogen activator (r-tPA) at 9 h from TLSW. An immediate diagnostic angiogram with intention to treat, owing to the presence of large vessel occlusion, showed complete reperfusion after intravenous r-tPA. She was discharged with NIHSS of 2, and at 3-month follow up her Modified Rankin Scale was 0. We demonstrated a successful reperfusion and excellent clinical recovery with intravenous thrombolysis in a patient who presented with a wake-up stroke with underlying valvular atrial fibrillation despite evidence of large vessel occlusion. © 2018, Royal College of Physicians of Edinburgh. All rights reserved. |
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