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All Journal Journal of Pain, Vertigo and Headache
Widyantari, Diryati
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Neuroscience

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BREAKING BARRIERS: FIRST SUCCESSFUL THROMBOLYSIS FOR HYPERACUTE ISCHEMIC STROKE IN A REGIONAL HOSPITAL (SERANG DISTRICT CASE REPORT) Widyantari, Diryati; Fahmi, Chaidir Aulia
Journal of Pain, Headache and Vertigo Vol. 7 No. 2 (2026): September
Publisher : PERDOSNI (Perhimpunan Dokter Spesialis Neurologi Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Background: Stroke is the leading cause of disability worldwide, with ischemic stroke comprising up to 80% of cases. Code stroke activation with intravenous thrombolysis is the recommended treatment for eligible patients within 4.5 hours of symptom onset. Reports from secondary health care facilities remain limited. Case Report: A 57-year-old woman presented to the emergency department with sudden-onset left-sided weakness and aphasia, 2 hours after onset. Examination showed left hemiparesis (motor strength 3), global aphasia, dysarthria, and tongue weakness, with an NIHSS score of 14. Brain CT scan suggested early ischemic changes. Random blood glucose was 103 mg/dL. After confirming eligibility and obtaining informed consent, intravenous alteplase was administered within 60 minutes. During infusion, her neurological deficits improved, with NIHSS reduced to 8. She was admitted to the intensive care unit for observation with NIHSS score downed into 3. By the next day, motor strength was restored (5-/5-), with NIHSS 1. She was discharged on day three without neurological deficits (NIHSS 0). Conclusion: This case represents an important milestone in our institution, showing that code stroke protocols can be successfully implemented in regional hospitals. Prompt thrombolysis in patients with moderate ischemic stroke may result in complete recovery and prevent long-term disability.
Co-Authors Fahmi, Chaidir Aulia