Sturge-Weber Syndrome With Leptomeningeal Angiomatosis and Middle Cerebral Artery Narrowing Treated With Intravenous Tissue Plasminogen Activator (IV tPA): A Case Report

Sturge-Weber syndrome (SWS) is a rare and congenitally acquired neurocutaneous disorder characterized by port wine stain, leptomeningeal angiomas with or without glaucoma. Clinical presentation includes focal motor epilepsy as the first symptom. They may also develop migraines, cognitive impairment, blindness secondary to glaucoma, and transient stroke-like episodes. We report a case of a 60-year-old patient with SWS with known leptomeningeal angiomatosis presenting with aphasia in the setting of left middle cerebral artery narrowing who received intravenous tissue plasminogen activator (IV tPA). Neurocutaneous syndromes associated with intracranial vascular malformations have been considered at a higher risk of intracranial bleeding following IV thrombolytic therapy. We report the first case to our knowledge in which a patient with SWS with known leptomeningeal angiomatosis received IV tPA for acute stroke therapy without intracranial bleeding.