Case Studies
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Introduction
This case study examines the treatment of a 54-year-old patient presenting with an acute ischemic stroke with a large vessel occlusion, showcasing our approach to emergency intervention.
Patient Background
The patient, a 54-year-old male with a history of hypertension and diabetes, presented with sudden onset of right-sided weakness and impaired speech.
Diagnostic Assessment
Initial examination showed a NIH stroke scale score of 18. An urgent CT angiogram revealed a left middle cerebral artery occlusion.
Treatment Plan
Given the patient’s presentation within the treatment window, we proceeded with mechanical thrombectomy. Under fluoroscopic guidance, a stent retriever was successfully deployed, and the occlusion was removed on the first pass.
Red arrow point to blockage of middle cerebral artery.
Stent retriever inserted into Middle Cerebral Artery (red arrows point to the markers bands of the stent retriever)
After removal of the blood clot the middle cerebral artery is now open (red arrow). The yellow arrows point to the distal circulation that was restored by opening the middle cerebral artery
Stent retriever with the removed blood clot
Outcome and Follow-Up
Post-procedure, the patient showed immediate improvement in motor skills and speech. At the three-month follow-up, the patient had a modified Rankin Scale score of 1, indicating minor symptoms but no significant disability. No further interventions have been required.
Discussion
This case underscores the importance of rapid response in acute stroke management and the efficacy of mechanical thrombectomy in large vessel occlusions. Our experience suggests potential areas for reducing response times and highlights the importance of patient education on stroke symptoms.