Successful stroke thrombolysis beyond guidelines: a case series
Intravenous (IV) thrombolysis is a safe and effective treatment for acute ischemic stroke. The therapeutic benefit is not extended to more than 4.5 hours in many patients due to the protocol’s time window restriction. Here, we reported two acute stroke cases with a moderate National Institutes of...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Published: |
Amaltea Medical Publishing House AMPH
2022
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| Online Access: | http://psasir.upm.edu.my/id/eprint/103351/ |
| _version_ | 1848863996445196288 |
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| author | Ibrahim, Azliza Al Khafiz, Mohd Fandi Anna Misyail Payus, Alvin Oliver Yap, Moon Yan Khan, Abdul Hanif Loh, Wei Chao Janudin Maz Anirah Liyana Najwa Wan Alia Kee, Hoo Fan Basri, Hamidon |
| author_facet | Ibrahim, Azliza Al Khafiz, Mohd Fandi Anna Misyail Payus, Alvin Oliver Yap, Moon Yan Khan, Abdul Hanif Loh, Wei Chao Janudin Maz Anirah Liyana Najwa Wan Alia Kee, Hoo Fan Basri, Hamidon |
| author_sort | Ibrahim, Azliza |
| building | UPM Institutional Repository |
| collection | Online Access |
| description | Intravenous (IV) thrombolysis is a safe and effective treatment for acute ischemic stroke. The therapeutic benefit is not
extended to more than 4.5 hours in many patients due to the protocol’s time window restriction. Here, we reported two
acute stroke cases with a moderate National Institutes of Health Stroke Scale (NIHSS) and onset greater than 4.5 hours
that were successfully thrombolysed with intravenous recombinant tissue plasminogen activator (tPA) - low-dose
Tenecteplase (TNK). The decision to thrombolysed both patients were based on Magnetic Resonance Imaging (MRI) Diffusion-weighted imaging (DWI)-Fluid Attenuation Inversion Recovery (FLAIR) mismatch – tissue basis rather than a time
window, and this resulted in a good neurological recovery with a significant improvement in functional Modified Rankin
Score (MRS) to zero at 90 days post stroke regardless of the stroke aetiology. In summary, Intravenous thrombolysis in
acute ischemic stroke outside the therapeutic window but with significant penumbra based on MRI DWI-FLAIR tissue
mismatch resulted in a remarkable neurological recovery after 90 days. |
| first_indexed | 2025-11-15T13:41:47Z |
| format | Article |
| id | upm-103351 |
| institution | Universiti Putra Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-15T13:41:47Z |
| publishDate | 2022 |
| publisher | Amaltea Medical Publishing House AMPH |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | upm-1033512023-06-14T03:45:56Z http://psasir.upm.edu.my/id/eprint/103351/ Successful stroke thrombolysis beyond guidelines: a case series Ibrahim, Azliza Al Khafiz, Mohd Fandi Anna Misyail Payus, Alvin Oliver Yap, Moon Yan Khan, Abdul Hanif Loh, Wei Chao Janudin Maz Anirah Liyana Najwa Wan Alia Kee, Hoo Fan Basri, Hamidon Intravenous (IV) thrombolysis is a safe and effective treatment for acute ischemic stroke. The therapeutic benefit is not extended to more than 4.5 hours in many patients due to the protocol’s time window restriction. Here, we reported two acute stroke cases with a moderate National Institutes of Health Stroke Scale (NIHSS) and onset greater than 4.5 hours that were successfully thrombolysed with intravenous recombinant tissue plasminogen activator (tPA) - low-dose Tenecteplase (TNK). The decision to thrombolysed both patients were based on Magnetic Resonance Imaging (MRI) Diffusion-weighted imaging (DWI)-Fluid Attenuation Inversion Recovery (FLAIR) mismatch – tissue basis rather than a time window, and this resulted in a good neurological recovery with a significant improvement in functional Modified Rankin Score (MRS) to zero at 90 days post stroke regardless of the stroke aetiology. In summary, Intravenous thrombolysis in acute ischemic stroke outside the therapeutic window but with significant penumbra based on MRI DWI-FLAIR tissue mismatch resulted in a remarkable neurological recovery after 90 days. Amaltea Medical Publishing House AMPH 2022 Article PeerReviewed Ibrahim, Azliza and Al Khafiz, Mohd Fandi and Anna Misyail and Payus, Alvin Oliver and Yap, Moon Yan and Khan, Abdul Hanif and Loh, Wei Chao and Janudin and Maz Anirah and Liyana Najwa and Wan Alia and Kee, Hoo Fan and Basri, Hamidon (2022) Successful stroke thrombolysis beyond guidelines: a case series. Romanian Journal of Neurology, 21 (1). 90 - 94. ISSN 1843-8148; ESSN: 2069-6094 https://rjn.com.ro 10.37897/RJN.2022.1.17 |
| spellingShingle | Ibrahim, Azliza Al Khafiz, Mohd Fandi Anna Misyail Payus, Alvin Oliver Yap, Moon Yan Khan, Abdul Hanif Loh, Wei Chao Janudin Maz Anirah Liyana Najwa Wan Alia Kee, Hoo Fan Basri, Hamidon Successful stroke thrombolysis beyond guidelines: a case series |
| title | Successful stroke thrombolysis beyond guidelines: a case series |
| title_full | Successful stroke thrombolysis beyond guidelines: a case series |
| title_fullStr | Successful stroke thrombolysis beyond guidelines: a case series |
| title_full_unstemmed | Successful stroke thrombolysis beyond guidelines: a case series |
| title_short | Successful stroke thrombolysis beyond guidelines: a case series |
| title_sort | successful stroke thrombolysis beyond guidelines: a case series |
| url | http://psasir.upm.edu.my/id/eprint/103351/ http://psasir.upm.edu.my/id/eprint/103351/ http://psasir.upm.edu.my/id/eprint/103351/ |