Resumen

FRANCO, Fabián; RUIZ PRIETO, Nidia Viviana  y  SCHMIDT MARON, Loiani Ayessa. Thrombolysis in ischemic stroke during the window period at the Ciudad del Este Regional Hospital of the Instituto de Previsión Social in 2023, Paraguay. Rev. virtual Soc. Parag. Med. Int. [online]. 2025, vol.12, n.1, e12142513.  Epub 21-Jul-2025. ISSN 2312-3893.  https://doi.org/10.18004/rvspmi/2312-3893/2025.e12142513.

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.

Palabras clave : thrombotic stroke; thrombolytic therapy; tissue plasminogen activator; risk factors; emergency medicine.

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