A 67 year old man with a history of hypertention presented to emergency department at Can Tho SIS hospital. The disease started suddenly about 1 hours before the patient was admitted to the hospital, the patient has begun to weakness in the left side, no treatment, unremitting à admitted.
Admission date: 6:05.am 14th of Juanary 2021
Clinical examination
Vital sign:
Pulse 94 bpm, Temp 37oC, BP 170/100 mmHg, RR 20 bpm, weight: 70kg
Neurologic exams:
GCS 15 points
Speech difficulty
Pupil reflex (+) on both sides, size #3mm
Central facial palsy on the left side of the body
Manual muscle test: right leg 5/5, right arm 5/5, left leg 2/5, left arm 2/5
NIHSS: 6 points
Cardiac and pulmonary exams: No
Initial diagnosis:
Acute ischemic stroke about poterior limb of internal capsule
Initial treatment:
Thrombolytic therapy on 06:35
(P=70kg, dose: 0,9mg/kg=63mg)
Alteplase: Bolus 6,3mg (≈ 6,3ml); infusion: 56,7mg/h (≈ 56.7 ml/h)
Indication for DSA
The head CT after 18h of intervention show no bleeding:
After 24h of treatment:
•The patient has good contact
•Stable vital signs
•Decrease central facial palsy on the left side of the body
•No speech difficulty
•Manual muscle test: right leg 5/5, right arm 5/5, left leg 5/5, left arm 5/5
-->Clinical assessment shows that the patient has improved
Admission date: 6:05.am 14th of Juanary 2021
Clinical examination
Vital sign:
Pulse 94 bpm, Temp 37oC, BP 170/100 mmHg, RR 20 bpm, weight: 70kg
Neurologic exams:
GCS 15 points
Speech difficulty
Pupil reflex (+) on both sides, size #3mm
Central facial palsy on the left side of the body
Manual muscle test: right leg 5/5, right arm 5/5, left leg 2/5, left arm 2/5
NIHSS: 6 points
Cardiac and pulmonary exams: No
Initial diagnosis:
Acute ischemic stroke about poterior limb of internal capsule
Initial treatment:
Thrombolytic therapy on 06:35
(P=70kg, dose: 0,9mg/kg=63mg)
Alteplase: Bolus 6,3mg (≈ 6,3ml); infusion: 56,7mg/h (≈ 56.7 ml/h)
Indication for DSA
The head CT after 18h of intervention show no bleeding:
After 24h of treatment:
•The patient has good contact
•Stable vital signs
•Decrease central facial palsy on the left side of the body
•No speech difficulty
•Manual muscle test: right leg 5/5, right arm 5/5, left leg 5/5, left arm 5/5
-->Clinical assessment shows that the patient has improved
