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Case Reports
. 2022;58(1):5.
doi: 10.1186/s41983-021-00434-w. Epub 2022 Jan 10.

Case series of intravenous thrombolysis for acute ischemic stroke in confirmed COVID-19 patients: single-centre experience

Ahmad Sulaiman Alwahdy  1 , Ika Yulieta Margaretha  1 , Kenyo Sembodro Pramesti  2 , Nailaufar Hamro  2 , Viska Yuzella  2 , Fitriani Nasution  1 , Arfan Mappalilu  1
Affiliations
Case Reports

Case series of intravenous thrombolysis for acute ischemic stroke in confirmed COVID-19 patients: single-centre experience

Ahmad Sulaiman Alwahdy et al. Egypt J Neurol Psychiatr Neurosurg. 2022.

Abstract

Background: Coronavirus disease 2019 (COVID-19) not only caused a large surge of respiratory infections, it also had a potential association with and increases the risk of stroke. The pandemic has certainly provided new challenges and opportunities in the management of acute ischemic stroke (AIS); however, data regarding outcomes of intravenous tissue plasminogen activator (IV TPA) administration in stroke patients with COVID-19 remains limited.

Case presentation: Three AIS patients with confirmed COVID-19 treated using IV tPA. One case had excellent outcome, while the other cases showed unfavorable results. The risk-benefit ratio of IV TPA in COVID-19 remains unclear.

Conclusion: In this article, we discuss the possible explanation behind these different outcomes. Although IV tPA could not cure COVID-19, we suggest that its administration should not be delayed in AIS patients with COVID-19.

Keywords: COVID-19; Case series; Intravenous thrombolysis; Ischemic stroke; Rt-PA.

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Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Imaging of ischemic stroke patients with COVID-19. A CT brain from case 1, showing hypodensities in left ganglia basal, insula and internal capsule. B Case 2, hypodensities were not found, MCA dense sign were prominent (black arrow). MCA middle cerebral artery
Fig. 2
Fig. 2
Head CT Scan A Before thrombolysis showed infarct in capsula eksterna sinistra cornu anterior, B After thrombolysis showed bleeding in lateral ventricle bilateral especially in the right and third ventricle
Fig. 3
Fig. 3
Possible mechanism of thrombosis and effect of trombolysis drugs in COVID-19
See this image and copyright information in PMC

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