title: Intra-arterial tissue plasminogen activator for an ischemic stroke in a 21-year-old Hispanic woman with elevated beta human chorionic gonadotropin and complex clinical history.
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.
authors.affiliation: Orvis School of Nursing, University of Nevada, Reno, NV, USA. ngreen@unr.edu
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Green
mesh_terms: D019969:Amphetamine-Related Disorders / Q000150:complications; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006801:Humans; D007269:Injections, Intra-Arterial; D017058:Mexican Americans; D011247:Pregnancy; D011248:Pregnancy Complications; D020521:Stroke / Q000150:complications / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator