Case Report:Recombinant Tissue Plasminogen Activator Thrombolysis in Acute Ischemic Stroke First Case Report in Manipur

Abstract

Cerebrovascular disease represents an enormous burden of disease and disability to mankind. Intravenous thrombolysis with recombinant tissue plasminogen activator(rtpa) within 3hr of symptomonset is currently approved for treatment of acute ischaemic stroke. Though it is widely used in western countries, the use of IV(intravenous) thrombolysis in peripherally located hospital is still a problem because for its short window period of 3hr of stroke onset.Here we are reporting the first case of IV thrombolysis in RIMS with recombinant tissue plasminogen activator(rtpa) recently. 78 years old man presented to us with right hemiparesis, power (1/5), global aphasia and altered sensorium. Patient presented to us at around one and half hour of stroke. At the time of presentation patient National institute of health stroke scale(NIHSS) score was 12 and Barthel index was 0. CT head done show no infraction, patient was thrombolysedwith 50mgActilyse(alteplase) within 30 minute of arrival to the hospital. Patient started improvement within 30 minute of starting thrombolysis, after 12hr of thrombolysis patient had power(4/5) with mild sensory aphasia. Repeat CT shows large left Middle cerebral artery(MCA) infract and CT angiography shows normal circle of willis.