<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2312-3893</journal-id>
<journal-title><![CDATA[Revista Virtual de la Sociedad Paraguaya de Medicina Interna]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. virtual Soc. Parag. Med. Int.]]></abbrev-journal-title>
<issn>2312-3893</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2312-38932025000100413</article-id>
<article-id pub-id-type="doi">10.18004/rvspmi/2312-3893/2025.e12142513</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Trombólisis en ictus isquémico en periodo de ventana en el Hospital Regional Ciudad del Este del Instituto de Previsión Social en 2023, Paraguay]]></article-title>
<article-title xml:lang="en"><![CDATA[Thrombolysis in ischemic stroke during the window period at the Ciudad del Este Regional Hospital of the Instituto de Previsión Social in 2023, Paraguay]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Franco]]></surname>
<given-names><![CDATA[Fabián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruiz Prieto]]></surname>
<given-names><![CDATA[Nidia Viviana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Schmidt Maron]]></surname>
<given-names><![CDATA[Loiani Ayessa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Privada del Este Facultad de Medicina ]]></institution>
<addr-line><![CDATA[Ciudad del Este ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<volume>12</volume>
<numero>1</numero>
<fpage>413</fpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2312-38932025000100413&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2312-38932025000100413&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2312-38932025000100413&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN El accidente cerebrovascular (ACV) es una emergencia neurológica de inicio súbito, clasificado en isquémico (80% de los casos) y hemorrágico, con alta incidencia en países de bajos y medianos ingresos. Los factores de riesgo incluyen hipertensión arterial (principal factor modificable), edad avanzada, diabetes mellitus y sexo masculino. Se presenta un caso clínico de un hombre de 60 años con ACV isquémico en el Hospital Regional IPS de Ciudad del Este, Paraguay, quien ingresó con cefalea intensa, hemiplejía derecha, disartria e hipertensión. A pesar de negar antecedentes de hipertensión, su diabetes mellitus tipo 2 y edad lo situaron en alto riesgo. La tomografía computarizada descartó hemorragia, permitiendo la administración de alteplasa (0,9 mg/kg) dentro de la ventana terapéutica (0-3 horas), con mejoría notable del déficit neurológico. Considerando la elevada incidencia anual de casos y la importancia crítica del tratamiento oportuno -el cual reduce en un 20% la mortalidad durante la fase aguda y en un 30% las secuelas discapacitantes-, resulta alarmante la brecha asistencial existente en nuestro medio. Esta situación conduce a que numerosos pacientes no reciban una intervención terapéutica que, cuando se aplica adecuadamente como en este caso, ofrece resultados óptimos en términos de recuperación funcional y supervivencia.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT A cerebrovascular accident (CVA) is a sudden-onset neurological emergency classified as ischemic (80% of cases) or hemorrhagic, with a high incidence in low- and middle-income countries. Risk factors include high blood pressure (the main modifiable factor), advanced age, diabetes mellitus, and male gender. We present a clinical case of a 60-year-old man with ischemic stroke at the IPS Regional Hospital in Ciudad del Este, Paraguay, who was admitted with severe headache, right hemiplegia, dysarthria, and hypertension. Although he denied a history of hypertension, his type 2 diabetes mellitus and age placed him at high risk. Computed tomography ruled out hemorrhage, allowing the administration of alteplase (0.9 mg/kg) within the therapeutic window (0-3 hours), with notable improvement in neurological deficit. Considering the high annual incidence of cases and the critical importance of timely treatment-which reduces mortality during the acute phase by 20% and disabling sequelae by 30%-the existing gap in care in our setting is alarming. This situation means that many patients do not receive therapeutic intervention, which, when applied appropriately as in this case, offers optimal results in terms of functional recovery and survival.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[accidente cerebrovascular trombótico]]></kwd>
<kwd lng="es"><![CDATA[terapia trombolítica]]></kwd>
<kwd lng="es"><![CDATA[activador de tejido plasminógeno]]></kwd>
<kwd lng="es"><![CDATA[factores de riesgo]]></kwd>
<kwd lng="es"><![CDATA[medicina de emergencia]]></kwd>
<kwd lng="en"><![CDATA[thrombotic stroke]]></kwd>
<kwd lng="en"><![CDATA[thrombolytic therapy]]></kwd>
<kwd lng="en"><![CDATA[tissue plasminogen activator]]></kwd>
<kwd lng="en"><![CDATA[risk factors]]></kwd>
<kwd lng="en"><![CDATA[emergency medicine]]></kwd>
</kwd-group>
</article-meta>
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