Successful thrombolysis of a wake-up stroke aided by Computed Tomography Perfusion (CTP) imaging: A case report

Abstract

(CTP) inability Abstract An 80-year-old man admitted with 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