Timely Intervention: A Success Story in Acute Stroke Management

Authors: Dr. Ashish Susvirkar and Dr. Ankur Gupta

In the realm of healthcare, every second counts, especially when it comes to addressing critical conditions like strokes. A recent case at Sterling Ram Krishna Specialty Hospital, Gandhidham, underscores the importance of prompt diagnosis and intervention in ensuring positive outcomes for patients.

The patient in question, a 69-year-old gentleman, presented with a complex medical history including hypertrophic cardiomyopathy (HCM), a past episode of right hemiparesis in 2020, and a seizure in 2021. Despite no seizure recurrence since then, his echocardiogram revealed a declining ejection fraction (EF). On January 22, 2024, at 5:45 PM, he experienced dysarthria and slight dull sensorium, prompting his relatives to seek urgent medical attention.

Upon arrival at the hospital, the patient exhibited left gaze paresis, right nystagmus, mild ataxia in both upper limbs, and non-cooperative lower limbs, alongside a withdrawal response. An urgent MRI revealed a suggestive acute infarct in the left pons, warranting immediate intervention.

After careful consideration and thorough explanation of risks, benefits, and cost factors, the patient's relatives consented to intravenous thrombolysis. The treatment commenced at 7:49 PM, administered by senior neurologist Dr. Ashish Anand S. Subsequent MR angiography hinted at a left vertebral occlusion and a potential thrombus in the proximal segment of the basilar artery.

With a multidisciplinary approach, involving consultation with neurosurgeon Dr. Ankur Gupta Ji, the patient underwent digital subtraction angiography (DSA) and interventional procedures. Remarkably, the patient's condition exhibited improvement by the second and third days post-stroke, with significant progress in gaze and ataxia.

Five days post-admission, the patient was discharged in a fully stable and vastly improved condition, highlighting the efficacy of comprehensive stroke care at Sterling Ram Krishna Specialty Hospital. This case serves as a testament to the pivotal role of timely diagnosis and intervention in mitigating the consequences of strokes and facilitating patient recovery.

In conclusion, the success story of this 69-year-old gentleman underscores the significance of a proactive approach to stroke management. By promptly identifying and addressing stroke symptoms, coupled with specialized interventions such as thrombolysis and interventional procedures, hospitals can significantly enhance patient outcomes and quality of life.

Furthermore, the collaborative efforts of a dedicated stroke care team comprising neurophysicians and stroke interven-tionists play a pivotal role in achieving such favorable results. Sterling Ram Krishna Specialty Hospital stands as a beacon of excellence in stroke care, equipped with state-of-the-art imaging facilities and ancillary services, ensuring comprehensive and effective management of stroke cases.

As we reflect on this case, let it serve as a reminder of the critical importance of swift action in the face of stroke emergencies, ultimately saving lives and preserving neurological function.