Trombólisis intravenosa exitosa en infarto cerebral agudo en paciente con historia de macroadenoma y apoplejía hipofisaria

Thrombolysis with tissue plasminogen activator is probably recommended for patients with acute ischemic stroke and extra-axial intracranial neoplasm, but in those with a history of intracranial hemorrhage it is potentially harmful. Intravenous thrombolysis in acute ischemic stroke in patients with a history of pituitary macroadenoma and apoplexy with intratumoral bleeding has not been reported in the literature. We report the case of a young patient with an acute ischemic stroke in the territory of the left middle cerebral artery, M3 portion, National Institutes of Health Stroke Scale of 14 and modified Rankin scale of 0 at admission, with a history of pituitary macroadenoma and pituitary apoplexy and mild intratumoral bleeding successfully brought to intravenous thrombolysis. The decision to thrombolysis with tissue plasminogen activator for the management of acute ischemic stroke should be based on the evaluation of the expected risks and benefits on a case-by-case basis taking into account the current guidelines.