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

Koya Kutty, Shahedah and Ching, Soong Khoo and Wan Yahya, Wan Nur Nafisah and Ng, Chen Fei and Md Sari, Noor Ashikin and Mohd Yaakob, Mohd Naim and Osman, Syazarina Sharis and Zakaria, Rozman and Wan Zaidi, Wan Asyraf (2018) Successful intravenous thrombolysis of a wake-up stroke with underlying valvular atrial fibrillation. Journal of the Royal College of Physicians of Edinburgh, 48 (3). pp. 239-241. ISSN 1478-2715 E-ISSN 2042-8189

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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. © 2018, Royal College of Physicians of Edinburgh. All rights reserved.

Item Type:	Article (Journal)
Additional Information:	6909/70141
Uncontrolled Keywords:	: atrial fi brillation, computed tomography perfusion, r-tPA, wake-up stroke
Subjects:	R Medicine > RF Otorhinolaryngology
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine
Depositing User:	Mrs. Wan Salwati Wan Salleh
Date Deposited:	25 Jan 2019 14:02
Last Modified:	25 Jan 2019 14:02
URI:	http://irep.iium.edu.my/id/eprint/70141

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