IV Administration of Thrombolytic Therapy in a Case with Hemianopsia Symptoms

Intravenous thrombolytic therapy is useful also in the treatment of very mild ischemic strokes. The recent FDA guidelines have approved that IV administration of recombinant tissue plasminogen activator (rtPA) should be performed in the cases with NIHSS<5 despite its potential risks. The administration of IV thrombolytic therapy is recommended also in the patients with aphasia or hemianopsia. In routine clinical practice, there is a tendency to avoid thrombolytic therapy in the case with only low NIHSS score, aphasia or hemianopsia to eliminate the potential risks. Hemianopsia may significantly affect the daily life of young and active patients. In this paper, we have reported a case who was brought to emergency service due to the complaint of visual impairment and administered IV thrombolytic therapy for partial homonymous hemianopsia only on the left side detected by neurological examination.