Stroke thrombolysis at 5.5 hours based on computed tomography perfusion

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1 Citation (Scopus)

Abstract

A young man was admitted with sudden onset of right-sided weakness. He was assessed in the emergency department, and an immediate computed tomography (CT) perfusion study of the brain was arranged, which showed a left middle cerebral artery territory infarct with occlusion of the M1 segment. There was a significant penumbra measuring approximately 50% of the arterial territory. By the time his assessment was completed, it was 5.5 hours from the onset of symptoms. He was nonetheless administered intravenous recombinant tissue plasminogen activator (rtPA) based on the significant penumbra. He was discharged from the hospital after one week with significant residual deficit. At 2 months clinic follow-up, he showed almost complete recovery with a Modified Rankin Score of 1. We hope to demonstrate that a significant penumbra is an important determinant for good neurological recovery and outcome following stroke thrombolysis, even when patients present outside the 4.5 hours onset-to-treatment time window.

Original languageEnglish
Pages (from-to)79-82
Number of pages4
JournalMalaysian Journal of Medical Sciences
Volume21
Issue number2
Publication statusPublished - 2014

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Perfusion
Stroke
Tomography
Middle Cerebral Artery
Tissue Plasminogen Activator
Hospital Emergency Service
Brain
Therapeutics

Keywords

  • Computed tomography
  • Developing countries
  • Perfusion
  • rtPA
  • Stroke
  • Thrombolysis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Stroke thrombolysis at 5.5 hours based on computed tomography perfusion",
abstract = "A young man was admitted with sudden onset of right-sided weakness. He was assessed in the emergency department, and an immediate computed tomography (CT) perfusion study of the brain was arranged, which showed a left middle cerebral artery territory infarct with occlusion of the M1 segment. There was a significant penumbra measuring approximately 50{\%} of the arterial territory. By the time his assessment was completed, it was 5.5 hours from the onset of symptoms. He was nonetheless administered intravenous recombinant tissue plasminogen activator (rtPA) based on the significant penumbra. He was discharged from the hospital after one week with significant residual deficit. At 2 months clinic follow-up, he showed almost complete recovery with a Modified Rankin Score of 1. We hope to demonstrate that a significant penumbra is an important determinant for good neurological recovery and outcome following stroke thrombolysis, even when patients present outside the 4.5 hours onset-to-treatment time window.",
keywords = "Computed tomography, Developing countries, Perfusion, rtPA, Stroke, Thrombolysis",
author = "Ramesh Sahathevan and {Md. Rani}, {Shahrul Azmin} and Sivakumar Palaniappan and {Wan Yahya}, {Wan Nur Nafisah} and Tan, {Hui Jan} and {Mohamed Ibrahim}, Norlinah and {Mohamed Mukari}, {Shahizon Azura}",
year = "2014",
language = "English",
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journal = "Malaysian Journal of Medical Sciences",
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T1 - Stroke thrombolysis at 5.5 hours based on computed tomography perfusion

AU - Sahathevan, Ramesh

AU - Md. Rani, Shahrul Azmin

AU - Palaniappan, Sivakumar

AU - Wan Yahya, Wan Nur Nafisah

AU - Tan, Hui Jan

AU - Mohamed Ibrahim, Norlinah

AU - Mohamed Mukari, Shahizon Azura

PY - 2014

Y1 - 2014

N2 - A young man was admitted with sudden onset of right-sided weakness. He was assessed in the emergency department, and an immediate computed tomography (CT) perfusion study of the brain was arranged, which showed a left middle cerebral artery territory infarct with occlusion of the M1 segment. There was a significant penumbra measuring approximately 50% of the arterial territory. By the time his assessment was completed, it was 5.5 hours from the onset of symptoms. He was nonetheless administered intravenous recombinant tissue plasminogen activator (rtPA) based on the significant penumbra. He was discharged from the hospital after one week with significant residual deficit. At 2 months clinic follow-up, he showed almost complete recovery with a Modified Rankin Score of 1. We hope to demonstrate that a significant penumbra is an important determinant for good neurological recovery and outcome following stroke thrombolysis, even when patients present outside the 4.5 hours onset-to-treatment time window.

AB - A young man was admitted with sudden onset of right-sided weakness. He was assessed in the emergency department, and an immediate computed tomography (CT) perfusion study of the brain was arranged, which showed a left middle cerebral artery territory infarct with occlusion of the M1 segment. There was a significant penumbra measuring approximately 50% of the arterial territory. By the time his assessment was completed, it was 5.5 hours from the onset of symptoms. He was nonetheless administered intravenous recombinant tissue plasminogen activator (rtPA) based on the significant penumbra. He was discharged from the hospital after one week with significant residual deficit. At 2 months clinic follow-up, he showed almost complete recovery with a Modified Rankin Score of 1. We hope to demonstrate that a significant penumbra is an important determinant for good neurological recovery and outcome following stroke thrombolysis, even when patients present outside the 4.5 hours onset-to-treatment time window.

KW - Computed tomography

KW - Developing countries

KW - Perfusion

KW - rtPA

KW - Stroke

KW - Thrombolysis

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JO - Malaysian Journal of Medical Sciences

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