case report of stroke patient

What was the diagnosis of stroke case 1?

CASE 1 A 20 year old man with no past medical history presented to a primary stroke center with sudden left sided weakness and imbalance followed by decreased level of consciousness. Head CT showed no hemorrhage, no acute ischemic changes, and a hyper-dense basilar artery. CT angiography showed a mid-basilar occlusion.

Where can I find more information on acute ischemic stroke treatment?

For more information on Acute Ischemic Stroke treatment, go to StrokeAssociation.org/AISToolkit Title PowerPoint Presentation Author Lindsey Minton Created Date 11/18/2016 2:25:23 PM

Does diffusion weighted imaging indicate irreversibly damaged tissue in acute stroke?

[…] In acute ischemic stroke, diffusion weighted imaging (DWI) shows hyperintensities and is considered to indicate irreversibly damaged tissue. We present the case of a young stroke patient with unusual variability in the development of signal intensities within the same vessel territory.

Is there variability in the development of signal intensities in stroke patients?

We present the case of a young stroke patient with unusual variability in the development of signal intensities within the same vessel territory. A 35-year-old patient presented with symptoms of global aphasia and hypesthesia of the left hand. MRI demonstrated a scattered lesion in the MCA territory.

Abstract

In acute ischemic stroke, diffusion weighted imaging (DWI) shows hyperintensities and is considered to indicate irreversibly damaged tissue. We present the case of a young stroke patient with unusual variability in the development of signal intensities within the same vessel territory.

Background

Acute cerebral ischemia can be visualized with MRI diffusion weighted imaging (DWI) within minutes after its onset [ 1 ]. It has been suggested that in the majority of human stroke patients DWI positive cerebral ischemia indicate irreversible tissue damage leading to infarction [ 2 ].

Case presentation

A 35 year old female patient was admitted with incomplete global aphasia and a fluctuating slight hypesthesia of the left hand. Her baseline National Institutes of Health Stroke Scale score (NIHSS) was 4 and arterial hypertension was the only vascular risk factor.

Conclusions

We demonstrated that the degree and time course of DWI hyperintensities can differ within one lesion in the first day after stroke. To the best of our knowledge, this is the first time that the exact time course of DWI reversal and reappearance was visualized using highly repetitive MRI examinations.

Acknowledgements

This research received funding from the Federal Ministry of Education and Research via the grant Center for Stroke Research Berlin (01EO0801 and 01EO1301).

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author (s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History of Presenting Condition

Michael is a 61 year old Senior Partner in a Law Firm. While eating breakfast Michael experienced sudden onset slurring of speech, had facial droop on his left hand side with weakness in left side upper and lower limbs. Michael's wife Mary spotted these sudden onset of symptoms and immediately called for an ambulance, which arrived within 15 mins.

Social History

61 Year Old Senior Partner at a Law Firm, recently reduced working hours 20 - 30 hours per week, previously worked 50 - 60 Hours

Pre-Hospital Assessment

Los Angeles Prehospital Stroke Screen (LAPSS) & Los Angeles Motor Scale (LAMS)

Investigations

Hyperdensity in the M1 Segment of the Right Middle Cerebral Artery, with no other signs suggestive of an Ischemic Stroke noted. Provisional diagnosis of Acute Ischemic Stroke secondary to occlusion of the M1 was made Patient was treated with intravenous Tissue Plasminogen Activator (tPA) at 1 h 54 min after symptom onset

Abstract and Figures

This case study examined the effect of Korean Medicine on a 72-year old male with a habitual history of smoking and drinking, and a family history of hypertension who had suffered an acute stroke. A couple of months later he complained of upper extremity weakness and was diagnosed with dysarthria.

References (9)

The purpose of this study was to assess the quality of the case reports in the Journal of Acupuncture Research (JAR). All case reports were retrieved from November 2017 to June 2020.