RESUMEN

Intravenous tissue plasminogen activator (t-PA) is currently approved by the US Food and Drug Administration (FDA) for the treatment of ischemic stroke in patients > 18 years of age who present within 3 hours of stroke onset and meet certain criteria. We report a case of a 16-year-old, previously healthy female who presented with a basilar artery occlusion and pontine ischemic stroke. She was treated with intravenous t-PA approximately 4 hours after the onset of symptoms. The patient demonstrated a remarkable recovery 6 hours after onset of her symptoms and had minimal deficits on discharge from the hospital 1 week later. She was found to have a lupus anticoagulant and was heterozygous for the prothrombin gene G2010A mutation. These were likely contributing causes for her stroke. She was also homozygous for plasminogen activator inhibitor 1 (PAI-1) 4G/4G, which at present is a controversial stroke risk factor.

Asunto(s)

Trastornos de la Coagulación Sanguínea Heredados/complicaciones , Trastornos de la Coagulación Sanguínea Heredados/genética , Predisposición Genética a la Enfermedad/genética , Activador de Tejido Plasminógeno/administración & dosificación , Insuficiencia Vertebrobasilar/tratamiento farmacológico , Insuficiencia Vertebrobasilar/genética , Adolescente , Arteria Basilar/efectos de los fármacos , Arteria Basilar/patología , Arteria Basilar/fisiopatología , Trastornos de la Coagulación Sanguínea Heredados/fisiopatología , Infartos del Tronco Encefálico/tratamiento farmacológico , Infartos del Tronco Encefálico/genética , Infartos del Tronco Encefálico/fisiopatología , Enfermedad de Crohn , Análisis Mutacional de ADN , Femenino , Fibrinolíticos/administración & dosificación , Pruebas Genéticas , Genotipo , Humanos , Inhibidor de Coagulación del Lupus/sangre , Inhibidor de Coagulación del Lupus/genética , Mutación/genética , Inhibidor 1 de Activador Plasminogénico/genética , Protrombina/genética , Recuperación de la Función/efectos de los fármacos , Factores de Tiempo , Resultado del Tratamiento , Insuficiencia Vertebrobasilar/fisiopatología