A Case Report of Capsule Warning Syndrome Treated with Tirofiban Bridging Dual Antiplatelet Therapy after Intravenous Thrombolysis with Alteplase

doi:10.3969/j.issn.1673-5765.2024.03.011

Abstract

Abstract: Capsule warning syndrome (CWS) is a group of rare clinical symptoms with frequent episodes of stereotyped neurological deficits, and easy progression to complete stroke. This study reported a case of CWS with paroxysmal speech inarticulateness and left limb weakness. Within 24 hours after intravenous thrombolysis with alteplase, the patient still had repeated episodes of stereotypical speech inarticulateness and left limb weakness. After assessing the risk, tirofiban was given within 24 hours after intravenous thrombolysis, and dual antiplatelet therapy was bridged 3 days later. The patient had no recurrence of neurological deficits. However, the timing of initiation of dual antiplatelet therapy after intravenous thrombolysis and the dual antiplatelet therapy program still need large-scale data to further explore.

Key words: Capsule warning syndrome; Alteplase; Intravenous thrombolysis; Tirofiban; Aspirin; Clopidogrel

摘要： 内囊预警综合征（capsule warning syndrome，CWS）是一组罕见的临床症状，具有反复发作刻板样神经功能缺损症状，易进展成完全性卒中的特点。本研究报道1例表现为发作性言语不清伴左侧肢体无力的CWS，该患者经阿替普酶静脉溶栓治疗后24 h内，仍反复发作刻板样言语不清、左侧肢体无力。经评估风险后，静脉溶栓后24 h内予以替罗非班抗血小板聚集治疗，3 d后桥接双重抗血小板聚集治疗，患者未再发作神经功能缺损症状。静脉溶栓治疗后启动抗血小板聚集时机以及抗血小板聚集的方案，仍需大规模数据进一步探讨。

关键词: 内囊预警综合征; 阿替普酶; 静脉溶栓; 替罗非班; 阿司匹林; 氯吡格雷

CLC Number:

ZHENG Jianhua, CUI Yanling, CAO Ying, DAI Jianwu. A Case Report of Capsule Warning Syndrome Treated with Tirofiban Bridging Dual Antiplatelet Therapy after Intravenous Thrombolysis with Alteplase[J]. Chinese Journal of Stroke, 2024, 19(3): 326-330.

郑剑华, 崔燕玲, 曹莹, 戴建武. 阿替普酶静脉溶栓后替罗非班桥接双重抗血小板聚集治疗内囊预警综合征病例报道[J]. 中国卒中杂志, 2024, 19(3): 326-330.

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