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Meenakshi-Sundaram et al. Neuroimmunol Neuroinflammation 2017;4:216-8 Neuroimmunology and
DOI: 10.20517/2347-8659.2016.57
Neuroinflammation

www.nnjournal.net
Case Report Open Access

Dramatic recovery from stroke following

intravenous thrombolysis in a patient

on prasugrel for recent percutaneous

coronary angioplasty

Salvadeeswaran Meenakshi-Sundaram , Palanikumar Subburamakrishnan , Jude Vinoth ,
3
2
1
Simon Victor Rajah Sanjeevi Madhan-Rajah , Somalinga Nagendran Karthik , Pandi Suresh 1
3
1
1 Department of Neurosciences, Apollo Speciality Hospitals, Lake View Road, KK Nagar, Madurai, Tamil Nadu 625020, India.
2 Department of Cardiology, Apollo Speciality Hospitals, Lake View Road, KK Nagar, Madurai, Tamil Nadu 625020, India.
3 Department of Emergency Services, Apollo Speciality Hospitals, Lake View Road, KK Nagar, Madurai, Tamil Nadu 625020, India.
Correspondence to: Dr. Salvadeeswaran Meenakshi-Sundaram, Department of Neurosciences, Apollo Speciality Hospitals, Lake View Road, KK
Nagar, Madurai, Tamil Nadu 625020, India. E-mail: drsundarsms@gmail.com
How to cite this article: Meenakshi-Sundaram S, Subburamakrishnan P, Vinoth J, Madhan-Rajah SVRS, Karthik SN, Suresh P. Dramatic
recovery from stroke following intravenous thrombolysis in a patient on prasugrel for recent percutaneous coronary angioplasty. Neuroimmunol
Neuroinflammation 2017;4:216-8.

Dr. Salvadeeswaran Meenakshi-Sundaram is a Senior Consultant and Associate Professor in the Department
of Neurosciences, Apollo Speciality Hospitals, Madurai, India. He is the recipient of Gold Medal and was the
Best Outgoing Student of the Year 2000, at National Institute of Mental Health and Neurosciences (NIMHANS),
Bangalore, India. He received the Best Research Paper Award at the 10th Annual Conference of Indian Academy
of Neurology (IAN), Lucknow, India, 2002. He is actively involved in acute stroke-related work.

ABSTRACT
Article history: The authors report the first case of thrombolysis in a patient already receiving both aspirin and
Received: 29 Dec 2016 prasugrel following a recent ischemic coronary event. A 55-year-old gentleman was treated
Accepted: 28 Mar 2017 for inferior wall myocardial infarction with aspirin, prasugrel and percutaneous angioplasty of
Published: 19 Oct 2017 right coronary artery. Three days following the procedure he developed acute ischemic stroke
due to a left middle cerebral artery infarction with a National Institute of Health Stroke Scale
Key words: (NIHSS) of 24 and was treated with alteplase. Therapy was interrupted after completion of 29
Intravenous thrombolysis, mg (for a body weight of 65 kg) dose due to oral bleeding. Fifteen minutes post thrombolysis
ischemic stroke, NIHSS was 5 and dropped to zero after 12 h. This report highlights the benefits of alteplase in
percutaneous coronary the context of several relative contraindications like the setting of acute myocardial infarction
angioplasty, treated with percutaneous intervention and high NIHSS.
prasugrel

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