Successful thrombolysis for acute ischemic stroke in the presence of hyposphagma: a clinical case report

Background. In cases with standard indications and contraindications for the treatment of acute stroke, urgent thrombolysis with intravenous tissue plasminogen activator provides undoubted benefit. However, atypical situations not described in standard treatment guidelines may occur in daily clinic...

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Main Authors: G. Ulianskaitė, A. Timinskaitė, J. Valaikienė
Format: Article
Language:English
Published: Vilnius University Press 2020-09-01
Series:Neurologijos seminarai
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Online Access:https://www.journals.vu.lt/neurologijos_seminarai/article/view/27735
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author G. Ulianskaitė
A. Timinskaitė
J. Valaikienė
author_facet G. Ulianskaitė
A. Timinskaitė
J. Valaikienė
author_sort G. Ulianskaitė
collection DOAJ
description Background. In cases with standard indications and contraindications for the treatment of acute stroke, urgent thrombolysis with intravenous tissue plasminogen activator provides undoubted benefit. However, atypical situations not described in standard treatment guidelines may occur in daily clinical practice. Hence, a clinical case of a patient with an acute ischemic stroke and concomitant ocular bleeding is presented. The medical team needed to urgently evaluate the additional risk of ocular bleeding and make the most appropriate decision on using thrombolytic stroke therapy. Case presentation. A 70-year-old female with acute right-sided weakness was admitted to the emergency department within 2.5 hours. Cerebral computed tomography revealed hyperacute ischemia in the left frontal-parietal area. The neurologist diagnosed an acute ischemic stroke in the left middle cerebral artery with mild right-sided hemiparesis, and the ophthalmologist diagnosed subconjunctival haemorrhage (i.e. hyposphagma). In the absence of absolute contraindications, intravenous thrombolysis with tissue plasminogen activator was performed. The neurological symptoms regressed within one day and the hyposphagma was significantly reabsorbed within three days. The patient was discharged without residual deficits. Conclusions. The presented clinical case contributes to the positive evidence that systemic thrombolysis is a safe and effective method for the treatment of an acute ischemic stroke in the presence of hyposphagma.
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spelling doaj-art-47593728bb5a4f14893a1fe29e24fdc42025-01-20T18:22:37ZengVilnius University PressNeurologijos seminarai1392-30642424-59172020-09-01243(85)10.29014/ns.2020.35Successful thrombolysis for acute ischemic stroke in the presence of hyposphagma: a clinical case reportG. Ulianskaitė 0A. Timinskaitė 1J. Valaikienė 2Vilnius University, LithuaniaVilnius University, LithuaniaVilnius University, Lithuania Background. In cases with standard indications and contraindications for the treatment of acute stroke, urgent thrombolysis with intravenous tissue plasminogen activator provides undoubted benefit. However, atypical situations not described in standard treatment guidelines may occur in daily clinical practice. Hence, a clinical case of a patient with an acute ischemic stroke and concomitant ocular bleeding is presented. The medical team needed to urgently evaluate the additional risk of ocular bleeding and make the most appropriate decision on using thrombolytic stroke therapy. Case presentation. A 70-year-old female with acute right-sided weakness was admitted to the emergency department within 2.5 hours. Cerebral computed tomography revealed hyperacute ischemia in the left frontal-parietal area. The neurologist diagnosed an acute ischemic stroke in the left middle cerebral artery with mild right-sided hemiparesis, and the ophthalmologist diagnosed subconjunctival haemorrhage (i.e. hyposphagma). In the absence of absolute contraindications, intravenous thrombolysis with tissue plasminogen activator was performed. The neurological symptoms regressed within one day and the hyposphagma was significantly reabsorbed within three days. The patient was discharged without residual deficits. Conclusions. The presented clinical case contributes to the positive evidence that systemic thrombolysis is a safe and effective method for the treatment of an acute ischemic stroke in the presence of hyposphagma. https://www.journals.vu.lt/neurologijos_seminarai/article/view/27735acute ischemic strokesubconjunctival haemorrhagehyposphagmathrombolysistissue plasminogen activatorcase report
spellingShingle G. Ulianskaitė
A. Timinskaitė
J. Valaikienė
Successful thrombolysis for acute ischemic stroke in the presence of hyposphagma: a clinical case report
Neurologijos seminarai
acute ischemic stroke
subconjunctival haemorrhage
hyposphagma
thrombolysis
tissue plasminogen activator
case report
title Successful thrombolysis for acute ischemic stroke in the presence of hyposphagma: a clinical case report
title_full Successful thrombolysis for acute ischemic stroke in the presence of hyposphagma: a clinical case report
title_fullStr Successful thrombolysis for acute ischemic stroke in the presence of hyposphagma: a clinical case report
title_full_unstemmed Successful thrombolysis for acute ischemic stroke in the presence of hyposphagma: a clinical case report
title_short Successful thrombolysis for acute ischemic stroke in the presence of hyposphagma: a clinical case report
title_sort successful thrombolysis for acute ischemic stroke in the presence of hyposphagma a clinical case report
topic acute ischemic stroke
subconjunctival haemorrhage
hyposphagma
thrombolysis
tissue plasminogen activator
case report
url https://www.journals.vu.lt/neurologijos_seminarai/article/view/27735
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