Thrombolytic treatment of ischaemic stroke occurring during a migrainous attack: A case report

Abstract

Authors report a case of young female suffering from the acute ischaemic stroke with right-sided hemiplegia, hemianopsia and hemihypoaesthesia during a migrainous attack without aura. Magnetic resonance imaging detected infarction in the left occipital lobe and occlusion of branches of the posterior cerebral artery (PCA). Combined treatment with systemic thrombolysis and sonothrombolysis was used, leading to the early PCA recanalization, and to a favourable clinical outcome after 1 month. Intravenous thrombolytic treatment administered within the therapeutic window may be useful in cerebral ischaemia associated with migraine when an arterial occlusion is documented.

Rare Complications of Migraine With Aura

“…There is one reported case of systemic thrombolytics being used to treat an acute stroke in a patient with migraine; however, in this case the patient did not have a prior history of migraine with aura and her symptoms of hemianopsia and hemiparesis began after the onset of an attack of migraine without aura. 36 This patient did have a good recovery and had no complications from receiving intravenous thrombolysis. There are no other reports of intravenous thrombolytics being used in MI; however, the use of thrombolytics should be considered when encountering patients who present to the emergency department with symptoms suggestive of an ischemic stroke without other contraindications.…”

“…The treatment of MI comes from clinical and expert experience, case reports, and theories regarding the pathophysiology of the disorder. There is one reported case of systemic thrombolytics being used to treat an acute stroke in a patient with migraine; however, in this case the patient did not have a prior history of migraine with aura and her symptoms of hemianopsia and hemiparesis began after the onset of an attack of migraine without aura . This patient did have a good recovery and had no complications from receiving intravenous thrombolysis.…”