<![CDATA[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.]]>
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