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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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Intravenous Tenecteplase for Acute Ischemic Stroke During Active Menstruation
Nathan A Baisden1, Jordan Preston1, Justin Nolte1
1Neurology, Marshall University Joan C. Edwards School of Medicine, Huntington, USA.
Cureus
|September 19, 2024
Summary
This case study discusses treating a menstruating woman with acute ischemic stroke using tenecteplase (TNK). The patient recovered fully without adverse events, suggesting TNK may be safe for menstruating women with stroke.
Area of Science:
- Neurology
- Emergency Medicine
- Pharmacology
Background:
- Acute ischemic stroke requires timely treatment with thrombolytic therapy.
- Intravenous tenecteplase (TNK) is increasingly used for acute ischemic stroke.
- Menstruation presents a potential relative contraindication for thrombolysis due to bleeding risk.
Observation:
- A 51-year-old female presented with stroke symptoms within the therapeutic window.
- Initial CT and CT perfusion imaging confirmed left parieto-occipital ischemia.
- The patient was actively menstruating, a potential relative contraindication for TNK.
Findings:
- Despite active menstruation, the patient received IV TNK after electing to proceed.
- No adverse events or complications related to bleeding occurred post-treatment.
- Neurological deficits completely resolved at the follow-up clinic visit.
Implications:
- This case highlights the need to consider TNK use in menstruating women with acute ischemic stroke.
- Active menstruation may not be an absolute contraindication for TNK if other factors are favorable.
- Further investigation is warranted to establish definitive guidelines for TNK use in this population.
