Recenzija, Prikaz slučaja
Repeated intravenous thrombolysis in recurrent ischemic stroke: a case report and review from the literature
Anita Arsovska
Marija Babunovska
Katina Aleksovska
Sažetak
Background
Recurrent strokes occur in 25% of the cases during the first 5 years after the initial event. Each recur- rent stroke increases the risk for severe disability and mortality. Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rtPA) is one of the therapeutic options when secondary prevention is not efficient and recurrent stroke occurs.
Aim
Aim of this paper is to present the first ever case of repeated IVT with rtPA in a female patient with recurrent stroke, hospitalized at the Department for Urgent Neurology, University Clinic of Neurology in Skopje, North Macedonia with a review from the literature.
Case presentation
A 59 years old female patient was admitted due to acute onset of motor and sensory dysphasia and right-sided hemiplegia. The symptoms occurred 1,5 hours before admission. Urgent computed tomography (CT) of the brain showed chronic cerebral infarction in the left and parietal regions, which causing traction of the left lateral ventricle. The patient experienced her first ischemic stroke 2,5 years ago and she was treated with IVT at the time. At the second hospital admission, the patient was conscious, with vital signs and urgent laboratory parameters within normal range. NIHSS score was 13 and a decision for IVT treatment was made. During the application of rtPA, her vital parameters were stable and no side effects were observed. Neurological status of the patient also improved, with NIHSS of 7 at the end of the IVT treatment. Control CT scan performed 24 hours after was without any new lesions. The patient was discharged in a stable condition, with a NIHSS of 4 and mRS of 3.
Conclusion
Repeated IVT in recurrent stroke is feasible and safe in carefully selected patients. Assessment of risk factors and neuroimaging are crucial when deciding on repeated IVT.
Ključne riječi
recurrent stroke, repeated intravenous thrombolysis, recombinant tissue plasminogen activator
Hrčak ID:
248904
URI
Datum izdavanja:
15.12.2020.
Posjeta: 2.229 *