Research Article
Intravenous Thrombolysis in Acute Ischemic Stroke: A Combined Audit and Young Stroke Subgroup Analysis from a Tertiary Centre in Northeast India
Bhutada A
Department of Neurology, GMCH Guwahati, Assam, India
*Corresponding author:Dr Akshay Bhutada, Department of Neurology, GMCH Guwahati, Assam, India Email Id: akshaythegiant@gmail.com
Article Information:Submission: 07/06/2025; Accepted: 22/07/2025; Published: 24/07/2025
Copyright: ©2025 Bhutada A. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background:Intravenous thrombolysis (IVT) is a well-established treatment modality in acute ischemic stroke (AIS), yet its realworld implementation varies regionally, especially in resource-limited settings like Northeast India. Furthermore, stroke in young adults (<50 years) represents a distinct subgroup with different etiological and outcome profiles. Intravenous Alteplase 0.9mg/kg was given in eligible patients.
Objective:To conduct a comprehensive audit of thrombolysis practices at a tertiary care center and to analyze clinical outcomes among young stroke patients undergoing IVT.
Methods:This retrospective observational study was conducted at the Department of Neurology, GMCH Guwahati. Among 444 ischemic stroke admissions, 29 patients received IVT between 2023 and 2024. Of these, 7 patients were under 50 years. Demographic, clinical, radiological, and outcome parameters were analyzed.
Results:The median NIHSS score before thrombolysis was 15. MCA territory involvement was universal. Post-thrombolysis NIHSS improved in 82.7% of cases. Overall mortality was 17.2%. Among young patients, the most common etiology was small vessel disease (TOAST Class 3), with favorable outcomes (mRS ≤2) in 57.1% and mortality in 28.6%.
Conclusion:IVT in AIS offers tangible functional benefits, including in younger adults. High mortality among young stroke despite early treatment emphasizes the need for early diagnosis and comprehensive care pathways.
Methods:This retrospective observational study was conducted at the Department of Neurology, GMCH Guwahati. Among 444 ischemic stroke admissions, 29 patients received IVT between 2023 and 2024. Of these, 7 patients were under 50 years. Demographic, clinical, radiological, and outcome parameters were analyzed.
Results:The median NIHSS score before thrombolysis was 15. MCA territory involvement was universal. Post-thrombolysis NIHSS improved in 82.7% of cases. Overall mortality was 17.2%. Among young patients, the most common etiology was small vessel disease (TOAST Class 3), with favorable outcomes (mRS ≤2) in 57.1% and mortality in 28.6%.
Conclusion:IVT in AIS offers tangible functional benefits, including in younger adults. High mortality among young stroke despite early treatment emphasizes the need for early diagnosis and comprehensive care pathways.
Keywords:Ischemic Stroke; Thrombolysis; Young Stroke; TOAST; NIHSS; mRS; MCA Infarct