A Case with 7 Min Door-To-Needle-Time and an Outline of Ultrarapid Stroke Management

Tissue plasminogen activator (t-PA) is the only approved thrombolytic therapy for the treatment of stroke patients. Its effectiveness is highly time dependent due to the sensitivity of brain tissue to ischemia. Therefore, it is crucial to minimize the time between the onset of symptoms and the initiation of an effective thrombolytic treatment. Here we describe a case that received an ultrarapid thrombolytic therapy. A 72-year-old woman was presented at our emergency department with a sudden occurrence of severe left sided hemiparesis. After exclusion of intracranial hemorrhage, the patient received intravenous thrombolysis therapy 7 min after arrival at our hospital. The patient showed a fast, nearly complete improvement of symptoms, and a minor infarction was detected in a follow up MRI. We describe this case and the general stroke management in our emergency department that led to this rapid door-to-needle time.