Case Reports
Successful thrombolysis of a wake-up stroke aided by Computed Tomography Perfusion (CTP) imaging: A case report
Authors:
Thilina Rathnasekara,
Teaching Hospital, Anuradhapura, LK
Manoj Chathuranga,
Teaching Hospital, Anuradhapura, LK
Koralegedara Dayaratne,
Teaching Hospital, Anuradhapura, LK
Thushara Muthunayake,
Teaching Hospital, Anuradhapura, LK
Prasanna Weerawansa,
Rajarata University of Sri Lanka, Saliyapura 50008, LK
About Prasanna
Department of Medicine, Faculty of Medicine and Allied Sciences
Hemal Senanayake
Rajarata University of Sri Lanka, Saliyapura 50008, LK
About Hemal
Department of Medicine, Faculty of Medicine and Allied Sciences
Abstract
An 80-year-old man was admitted with aphasia since wakeup. His Computed Tomography Perfusion (CTP) study of the brain revealed a significant but patchy penumbra with a minimal core. His Magnetic Resonance Imaging (MRI) also confirmed a mismatch between Diffusion-weighted MRI (DWI) and fluid-attenuated inversion recovery (FLAIR) sequences (DWI-FLAIR mismatch) supporting the existence of a significant ischaemic penumbra. He underwent thrombolysis with tenecteplase (TNK) after 5 hours and 40 minutes since waken up and had a good recovery with the improvement of the National Institute of Health Stroke Scale (NIHSS) from 5 to 0. Acute stroke patients could benefit from thrombolysis beyond the window period of 4.5 hours if there is a significant penumbra in the CT perfusion imaging and tenecteplase may have an added advantage over alteplase(r-tPA) in such circumstances.
How to Cite:
Rathnasekara, T., Chathuranga, M., Dayaratne, K., Muthunayake, T., Weerawansa, P. and Senanayake, H., 2022. Successful thrombolysis of a wake-up stroke aided by Computed Tomography Perfusion (CTP) imaging: A case report. Anuradhapura Medical Journal, 16(1), pp.21–25. DOI: http://doi.org/10.4038/amj.v16i1.7707
Published on
23 Mar 2022.
Peer Reviewed
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