Successful intravenous thrombolysis of a wake-up stroke with underlying valvular atrial fibrillation.

Successful intravenous thrombolysis of a wake-up stroke with underlying valvular atrial fibrillation. J R Coll Physicians Edinb. 2018 Sep;48(3):239-241 Authors: Shahedah KK, Khoo CS, Wan Nur Nafisah WY, Ng CF, Noor Ashikin I, Mohd Naim MY, Syazarina Sharis O, Rozman Z, Wan Asyraf WZ Abstract 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. PMID: 30191912 [PubMed - in process]
Source: Journal of the Royal College of Physicians of Edinburgh - Category: General Medicine Tags: J R Coll Physicians Edinb Source Type: research