TABLE 1

The timeline for the presented case.

DatesRelevant past medical history and interventions
She denied a history of hypertension, taking anticoagulant/antiplatelet medication, or trauma events.
Summaries from initial and follow-up visitsDiagnostic testing (including dates)Interventions
2020/1/3
  • Sudden-onset neck pain, right facial numbness, and right-sided weakness

  • Visiting our ER 2 hours later after the onset of symptoms

  • Hemoglobin level of 10.8 mg/dL and platelet count of 263,000/μL. (2020/1/3)

  • A coagulation test produced normal results. (2020/1/3)

  • A computed tomography (CT) scan of the brain revealed no intracranial hemorrhage. CT angiography revealed no evidence of major vessel occlusion or artery dissection. (2020/1/3)

  • Intravenous recombinant tissue plasminogen activator (rtPA) was administrated within 4.5 hours of symptom onset. (2020/1/3)

2020/1/3Left-side weakness developed 3 hours later rtPA injection
  • Subsequent magnetic resonance images of the brain and cervical spine revealed a mass in the right dorsal portion of the cervical canal above the C3 level that was compressing the spinal cord (2020/1/3)

  • Emergent laminectomy with hematoma removal 12 hours after symptom onset. (2020/1/3)

2020/1/8The motor strength of the left extremities recovered to grade 4
2020/1/21Discharge with right extremities recovered to grade 3
2020/2/5She could walk with walker