Posterior circulation stroke case report: Labuan Bajo’s first intravenous thrombolysis

Background. Intravenous thrombolysis is a widely accepted treatment for acute ischemic stroke, especially where advanced interventions like thrombectomy are unavailable. However, its use in posterior circulation strokes remains challenging due to diagnostic delays and treatment limitations. Case report. We report the first case of intravenous thrombolysis for posterior circulation ischemic stroke in Labuan Bajo, Flores Island. A 46-year-old male presented within 30 minutes of symptom onset but experienced a two-hour delay due to administrative issues. Despite deterioration in consciousness, alteplase was administered within the recommended time window. The pc-ASPECTS score was 8. The patient showed improvement in NIHSS from 19 to 12 post-thrombolysis, though further interventions were unavailable. Conclusions. This case highlights the potential benefit of intravenous thrombolysis in posterior circulation stroke, even with limited resources and moderate delays. It underscores the importance of timely intervention and contributes to data on thrombolysis in underserved regions.