Enzo  Sanzaro,
Thrombolytic Treatment in High-Risk Pregnancy: A Case Report
Neurology and Neurobiology
2020
2613-7828
http://dx.doi.org/10.31487/j.NNB.2020.02.06
https://www.sciencerepository.org/thrombolytic-treatment-in-high-risk-pregnancy-a-case-report_NNB-2020-2-106 
Abstract: Ischemic stroke during pregnancy occurs most often in the third trimester and is potentiated by an increased
pro-coagulant state during pregnancy. Precisely this procoagulant state, associated with other thrombophilic
phenomena and various risk factors for cardio- and cerebro-vascular pathologies, is the basis of a stroke in
the elderly pregnant woman. A 43-year-old woman of 30 weeks pregnant presented within 120 minutes of
the sudden onset of left side hemiparesis was given thrombolytic treatment with recombinant tissue
plasminogen activator. The risk was extremely high since in the past she had a premature birth for unknown
reasons. Our patient improved clinically with no residual deficits. But, being at risk, she was transferred to
another hospital where she spontaneously gave birth, after a few days, to a healthy premature baby. It is
reasonable to weigh in the benefit of alteplase vs. the risk in this patient group and give treatment for
disabling stroke, particularly if there is no access to endovascular treatment.
Keywords: Stroke, pregnancy, thrombolysis, elderly