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

K. K. Shahedah, C. S. Khoo, W. Y. Wan Nur Nafi Sah, C. F. Ng, I. Noor Ashikin, M. Y. Mohd Naim, Syazarina Sharis Osman, Rozman Zakaria, W. Z. Wan Asyraf

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)239-241
Number of pages3
JournalJournal of the Royal College of Physicians of Edinburgh
Volume48
Issue number3
DOIs
Publication statusPublished - 1 Jan 2018

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Keywords

  • Atrial fibrillation
  • Computed tomography perfusion
  • R-tPA
  • Wake-up stroke

ASJC Scopus subject areas

  • Education

Cite this

Shahedah, K. K., Khoo, C. S., Wan Nur Nafi Sah, W. Y., Ng, C. F., Noor Ashikin, I., Mohd Naim, M. Y., ... Wan Asyraf, W. Z. (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), 239-241. https://doi.org/10.4997/JRCPE.2018.308

Successful intravenous thrombolysis of a wake-up stroke with underlying valvular atrial fibrillation. / Shahedah, K. K.; Khoo, C. S.; Wan Nur Nafi Sah, W. Y.; Ng, C. F.; Noor Ashikin, I.; Mohd Naim, M. Y.; Osman, Syazarina Sharis; Zakaria, Rozman; Wan Asyraf, W. Z.

In: Journal of the Royal College of Physicians of Edinburgh, Vol. 48, No. 3, 01.01.2018, p. 239-241.

Research output: Contribution to journalArticle

Shahedah, K. K. ; Khoo, C. S. ; Wan Nur Nafi Sah, W. Y. ; Ng, C. F. ; Noor Ashikin, I. ; Mohd Naim, M. Y. ; Osman, Syazarina Sharis ; Zakaria, Rozman ; Wan Asyraf, W. Z. / Successful intravenous thrombolysis of a wake-up stroke with underlying valvular atrial fibrillation. In: Journal of the Royal College of Physicians of Edinburgh. 2018 ; Vol. 48, No. 3. pp. 239-241.
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