Third People's Hospital of Hainan Province, Sanya, Hainan, China.
Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.
Clin Exp Pharmacol Physiol. 2019 May;46(5):423-426. doi: 10.1111/1440-1681.13067. Epub 2019 Apr 1.
We report a case of a 105-year-old woman who was treated with Alteplase for acute ischaemic stroke (AIS). On arrival, this centenarian woman had sudden-onset aphasia and right-sided hemiparesis, her baseline National Institutes of Health Stroke Scale (NIHSS) score was 21. An acute noncontrast brain CT scan showed only mild white matter disease. After assessing the patient's risk-benefit ratio, the patient was administered intravenous Alteplase (0.9 mg/kg) 2.5 hours after symptom onset. Her right hemiparesis and aphasia eased within 24 hours after Alteplase treatment. At discharge, her NIHSS score had decreased to 1, leaving only mild right facial palsy unresolved. Few clinical data are available on centenarian patients with AIS who undergo intravenous thrombolysis. There are no data on what is the best method to use to manage centenarians. Our successful thrombolysis case indicates that biologically young centenarians may profit from thrombolysis, despite the very high age.
我们报告了一例 105 岁女性因急性缺血性脑卒中(AIS)接受阿替普酶治疗的病例。该百岁老人到达医院时突发语言障碍和右侧偏瘫,其基线国立卫生研究院卒中量表(NIHSS)评分为 21 分。急性非对比脑 CT 扫描仅显示轻度脑白质疾病。在评估患者的风险-获益比后,该患者在症状发作后 2.5 小时给予静脉注射阿替普酶(0.9mg/kg)。阿替普酶治疗后 24 小时内,她的右侧偏瘫和语言障碍得到缓解。出院时,她的 NIHSS 评分已降至 1 分,仅遗留轻度右侧面瘫未解决。百岁 AIS 患者接受静脉溶栓治疗的临床数据很少。对于如何管理百岁老人,尚无数据。我们成功的溶栓病例表明,尽管年龄非常高,但生物学上年轻的百岁老人可能从溶栓中获益。