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Thrombolysis with IV Tissue Plasminogen Activator for Acute Ischemic Stroke in 91 Years Female with Previous Stroke: A Case Report

Agrawal VK, Gupta R, Bansal A

Stroke can occur at any age, but with advancing age, risk for acute ischemic stroke increases by many fold. Mortality in acute stroke has reduced in last few years. The reason for the success are multi-factorial which includes preventive approach and improved care within the first few hours of acute stroke through thrombolysis with IV rtPA. However, thrombolysis for ischemic stroke in elderly beyond 80 years has been a debatable issue. We recently thrombolysed a 91 years old female with history of stroke in window period. Post thrombolysis, she regained full motor power without complications. In conclusion, very elderly age with Diabetes Mellitus and/or history of stroke should not be a contraindication for IV alteplase treatment in patients with acute ischemic stroke. We should weigh the risks and benefits of IV alteplase to treat acute ischemic stroke in such patients.

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