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intra-arterial, ischemic, stroke, tPA



  1. Green, Nicholas M.


ABSTRACT: The following case report discusses a 21-year-old Hispanic woman who was brought to the emergency room for evaluation because of experiencing acute left-sided hemiparesis with anosognosia. Upon further assessment, the patient was found to have a positive blood test for methamphetamines, positive human chorionic gonadotropin for pregnancy, and a history of patent foramen ovale. Neurological examination of the patient revealed left hemiparesis, dysarthria, and homonymous hemianopsia of the left side with a National Institutes of Health Stroke Scale of 12. Given the patient's assessment and positive radiological findings of a clot located within the right M1 segmental branch of the middle cerebral artery territory through the use of computed tomography angiography, deployment of intra-arterial thrombolytics within 6 hours of symptom onset was utilized. The patient's clinical course was complicated by brain swelling requiring intubation. Return of neurological function was assessed with noninvasive and invasive neurological evaluation, which showed full cognitive and physical return of the functional baseline level at discharge.