Thrombolysis as a Treatment for Ischemic Stroke: A Case Report
DOI:
https://doi.org/10.53089/medula.v14i3.891Keywords:
loss of consciousness, ischemic stroke, thrombolysisAbstract
Stroke is defined as a neurological deficit caused by an acute focal injury to the central nervous system, whether in the brain, retina, or spinal cord, caused by blood vessels. More than 13.7 million people suffer strokes every year, and around 70% of strokes are ischemic strokes. A 66-year-old man came to the RSAM emergency room with complaints of decreased consciousness since 3 hours of SMRS and weakness of the left limb. Physical examination revealed a Babinsky reflex (-/+), and a CT scan of the head without contrast showed thromboembolism in the right middle cerebral artery. The patient was treated with thrombolysis and medical therapy. The patient was discharged after one week of hospitalization and then scheduled for re-control at the polyclinic, and the patient's National Institute of Health Stroke Score (NIHSS) score was assessed. A total score of 5 was obtained with the interpretation of mild neurological deficits, which concluded that the patient's clinical condition had improved. Establishing diagnosis and therapy as early as possible is important for the key prognosis of ischemic stroke. Thrombolysis is the right choice as a treatment for ischemic stroke in patients who meet the inclusion criteria.
References
World Health Organization. Uganda Non-Communicable Diseases Factsheet. World Health Organization - Noncommunicable Diseases (NCD) Country Profiles. Published online 2018.
Jolugbo P, Ariëns RAS. Thrombus Composition and Efficacy of Thrombolysis and Thrombectomy in Acute Ischemic Stroke. Stroke. 2021;52(3). doi:10.1161/STROKEAHA.120.032810
Phipps MS, Cronin CA. Management of acute ischemic stroke. The BMJ. 2020;368. doi:10.1136/bmj.l6983
Sacco RL, Kasner SE, Broderick JP, et al. An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American heart association/American stroke association. Stroke. 2013;44(7). doi:10.1161/STR.0b013e318296aeca
Campbell BCV, Khatri P. Stroke. The Lancet. 2020;396(10244). doi:10.1016/S0140-6736(20)31179-X
Zhang LF, Yang J, Hong Z, et al. Proportion of different subtypes of stroke in China. Stroke. 2003;34(9). doi:10.1161/01.STR.0000087149.42294.8C
Calvet D, Touzé E, Oppenheim C, Turc G, Meder JF, Mas JL. DWI lesions and TIA etiology improve the prediction of stroke after TIA. Stroke. 2009;40(1). doi:10.1161/STROKEAHA.108.515817
Arch AE, Weisman DC, Coca S, Nystrom K V., Wira CR, Schindler JL. Missed Ischemic Stroke Diagnosis in the Emergency Department by Emergency Medicine and Neurology Services. Stroke. 2016;47(3). doi:10.1161/STROKEAHA.115.010613
Campbell BCV, De Silva DA, Macleod MR, et al. Ischaemic stroke. Nat Rev Dis Primers. 2019;5(1). doi:10.1038/s41572-019-0118-8
Trialists SU. Collaborative systematic review of the randomised trials of organised inpatient (stroke unit) care after stroke. Stroke Unit Trialists’ Collaboration. BMJ. 1997;314.
Zaheer Z, Robinson T, Mistri AK. Thrombolysis in acute ischaemic stroke: An update. Ther Adv Chronic Dis. 2011;2(2). doi:10.1177/2040622310394032
Campbell BCV, Meretoja A, Donnan GA, Davis SM. Twenty-Year History of the Evolution of Stroke Thrombolysis With Intravenous Alteplase to Reduce Long-Term Disability. Stroke; a journal of cerebral circulation. 2015;46(8). doi:10.1161/STROKEAHA.114.007564
Catanese L, Tarsia J, Fisher M. Acute Ischemic Stroke Therapy Overview. Circ Res. 2017;120(3). doi:10.1161/CIRCRESAHA.116.309278
Spokoyny I, Cederquist L, Clay B, Meyer BC. COAST (Coordinating Options for Acute Stroke Therapy): An Advance Directive for Stroke. J Clin Ethics. 2015;26(3).
Demaerschalk BM, Kleindorfer DO, Adeoye OM, et al. Scientific Rationale for the Inclusion and Exclusion Criteria for Intravenous Alteplase in Acute Ischemic Stroke A Statement for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke. 2016;47(2). doi:10.1161/STR.0000000000000086
Fugate JE, Rabinstein AA. Absolute and Relative Contraindications to IV rt-PA for Acute Ischemic Stroke. Neurohospitalist. 2015;5(3). doi:10.1177/1941874415578532
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