05/06/2025
A 55-year-old female with a history of hypertension (on treatment) and COPD Group E (on inhalational therapy) presented to the Emergency Department at District Hospital Pulwama with complaints of sudden onset left-sided weakness and slurring of speech for the past 1.5 hours.
On examination, the patient was found to have left hemiparesis. She was stabilized, an IV line was secured, and she was immediately shifted to the Radiology Department for brain imaging.
CT brain ruled out the possibility of intracranial hemorrhage, after consultation with the on-call radiologist. Given the patient’s clinical condition, being within the thrombolysis window period, and having an NIHSS score of 14, she was planned for intravenous thrombolysis after ruling out any contraindications.
The only relative contraindication noted was elevated blood pressure on arrival, which was successfully managed with IV antihypertensives.
The procedure, including potential complications, was explained to the patient’s attendants. After obtaining informed consent, the patient was thrombolysed with IV Tenecteplase.
Post-thrombolysis, the patient was monitored closely and no immediate complications were observed during the first 15 to 30 minutes.
The treating team included:
Dr. Syed Asif
Dr. Asif Jan
Dr. Ayaz Mir
Dr. Imran
Joziya Yakoob (Nursing Officer)
The team is highly thankful to the Medical Superintendent, District Hospital Pulwama, for his logistic support.
The patient was subsequently referred to the Neurology Department at SMHS Hospital for further management.