Abstract
We report a case of cerebral infarction during pregnancy which was treated using thrombolytic therapy with urokinase during a therapeutic window. A 34-year-old woman (at 39 weeks gestation) developed sudden onset of left side semi-paralysis and articulation disorder, and was admitted into our Emergency room 90 minutes later. Her National Institute of Health Stroke Scale (NIHSS) score was 8 prior to thrombolytic treatment. computed tomography (CT) demonstrated an attenuated cortico-medullary border in the middle cerebral artery (MCA) scans 2 hours after onset. Diffusion-weighted imaging by magnetic resonance imaging (MRI) revealed a high intensity area 2.5 hours after onset, which confirmed the CT findings. We indicated thrombolytic therapy with urokinase to the patient from several methods since we considered the potential benefits of this therapy to outweigh the risks to her and her fetus. After treatment, her NIHSS score improved. She delivered on Day 3, recovered, and was discharged on Day 17 without sequelae. In this rare case with such a limited time period, a clinical decision was difficult to make in considering the treatment effects on both the patient and her fetus. The indication of thrombolytic therapy to the cerebral infarction patient during pregnancy should be carefully considered.
