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A 61-year-old African–American man presented 1 hour after the onset of left-sided limb weakness and facial numbness. He was taking an ACE inhibitor for hypertension. One year before, he had developed an ischaemic left basal ganglia stroke, having presented 48 hours after the onset of symptoms. He had been medically managed with aspirin and high-intensity statin only and had recovered with no residual deficit.
On this second presentation he met the criteria for administration of alteplase (recombinant tissue plasminogen activator, tPA). …
Contributors Both listed authors have contributed to the drafting and writing of this article, as well as the care of the patient.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Not commissioned; externally peer reviewed by Anthony Pereira, London, UK.