and 4 other(s)
27 years female with 28 weeks pregnancy second gravida presented with right side hemiplesia with aphasia of 2 hours of duration, without any co-morbidity at Akluj Critical care and trauma centre Akluj India.On examination patient was hemodynamically stable with NIHSS-19. MRI brain showed left insular cortex and paraventricular infarct. Patient was thrombolysed with IV rTPA.Workup for cause of stroke was done including autoimmune workup colour doppler heart were normal. MRA showed left mca stenosis. Right hemiplegia recovered completely within 48 hours and aphasia in 2 weeks. Post stroke thrombolysis patient was maintained on aspirin 150 od. subsequently patient delivered normally with healthy babies. MRS at 3 months is 0. Conclusion- Our patient improved clinically with no residual deficits. There was no evidence of placental or fetal injury following administration of tPA on follow-up obstetrical evaluations.With limited resources at small town , Stroke thrombolysis with IV rTPA is always better option than managing conservatively as rTPA is large molecule does not cross placental barrier and it is used for thrombolysis of MI and PE during Pregnancy.
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