Intravenous Tenecteplase for Acute Global Aphasia: A Stroke Mimic Case of Migraine with Aphasic Aura in a Young Woman

A 29-year-old woman presented with sudden severe mixed aphasia and sensory symptoms mimicking acute stroke, receiving intravenous tenecteplase within the therapeutic window despite normal imaging and no large vessel occlusion. Complete neurological recovery occurred within hours; delayed MRI was normal, and the episode was ultimately attributed to migraine with aphasic aura rather than ischemic stroke, illustrating diagnostic challenges in hyperacute neurological presentations.