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A 25-year-old woman with an unremarkable medical history had an episode of acute weakness of her right arm and speech disturbance that had developed during the past 2 hours. She complained that she had also previously (during the last 8 hours before the onset of the last episode) experienced numerous episodes of transient right-arm weakness, which lasted only a few minutes and resolved spontaneously. She was evaluated by our acute stroke team as a potential candidate for intravenous thrombolysis. Her neurologic examination disclosed right hemiparesis and mild expressive aphasia, with a National Institutes of Stroke Scale score of 6 points.
Tsivgoulis G, Vadikolias K, Heliopoulos I, Mantatzis M, Souftas V, Piperidou C. Acute Cerebral Ischemia Owing to Unruptured Dissecting Intracranial AneurysmAn Uncommon Contraindication for Intravenous Thrombolysis. Arch Neurol. 2010;67(6):770-771. doi:10.1001/archneurol.2010.90