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Related Experiment Videos

Centenarian stroke treated with tissue-type plasminogen activator.

Mark J Gorman1, David Tanne, Christopher A Lewandowski

  • 1Department of Neurology, Wayne State University School of Medicine, Detroit, MI 48201, USA. mgorman@moose.med.wayne.edu

Cerebrovascular Diseases (Basel, Switzerland)
|May 16, 2002
PubMed
Summary

Tissue-type plasminogen activator (t-PA) treatment for acute ischemic stroke can be beneficial for very elderly patients. This case study shows rapid symptom resolution in a 100-year-old woman, suggesting careful consideration for thrombolysis in this population.

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Area of Science:

  • Neurology
  • Geriatrics
  • Emergency Medicine

Background:

  • Acute ischemic stroke outcomes are often poorer in elderly patients compared to younger individuals.
  • Tissue-type plasminogen activator (t-PA) is frequently withheld from very elderly patients due to comorbidities or concerns about safety.
  • This case explores the potential benefits of t-PA in the extremely old population.

Observation:

  • A 100-year-old woman presented with acute ischemic stroke symptoms including slurred speech and right-sided hemiparesis/hemisensory loss.
  • Computed tomography ruled out hemorrhage and early ischemic changes.
  • Intravenous t-PA was administered within the 3-hour window.

Findings:

  • The patient experienced rapid symptom resolution following t-PA administration.

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  • Her National Institutes of Health Stroke Scale (NIHSS) score improved from 12 on admission to 4 at one month.
  • She was discharged home after a 4-day hospital stay.

    • Implications:

    • Intravenous thrombolysis with t-PA may be a viable and beneficial treatment option for carefully selected very elderly patients with acute ischemic stroke.
    • Individualized risk-benefit analysis is crucial when considering t-PA for octogenarian and nonagenarian stroke patients.
    • This case supports the consideration of thrombolytic therapy in eligible elderly individuals, challenging the current practice of withholding it based solely on age.