Thrombolysis with Tenecteplase for Wake-Up Stroke in a 102-Year-Old Woman: A Case Report

Author : Sara Ibzea, Maryam Abdurrahman

Abstract :Background: Wake-up strokes, defined as strokes with symptoms first identified upon awakening, present clinical challenges due to uncertainty regarding the precise time of onset.Advanced imaging now allows some of these patients to safely receive thrombolysis. Tenecteplase, a newer thrombolytic, has practical advantages over alteplase, but its use in centenarians remains rare. Case presentation: We describe a 102-year-old woman who awoke with severe left-sided weakness. She had an initial NIHSS score of 24, indicating a significant stroke. Initial CT scans were clear, but advanced perfusion imaging showed a large amount of brain tissue still salvageable. After receiving tenecteplase, she improved dramatically, with her NIHSS score reducing to 3 by discharge. She experienced no complications from the treatment

Keywords :This case highlights that tenecteplase can be safely and effectively used in wake-up stroke patients, even those of advanced age, when supported by appropriate imaging.

Conference Name :INTERNATIONAL CONFERENCE ON RECENT ADVANCES IN MEDICAL AND HEALTH SCIENCES (ICRAMHS-25)

Conference Place Amman, Jordan

Conference Date 9th Aug 2025