Atypical presentation of an ischemic cerebrovascular event: a case report
DOI:
https://doi.org/10.61182/rnavmed.v9n1a3Keywords:
Ischemic stroke, Intravenous thrombolysis, Panangiography, Secondary prevention, Antiplatelet therapyAbstract
Stroke is a clinical condition that affects a high percentage of the population, is estimated to be the second leading cause of death in the world and is one of the main causes of disability. This event occurs mainly due to the obstruction of arterial blood flow in the brain and is closely associated with an increase in chronic noncommunicable diseases such as type 2 diabetes mellitus and arterial hypertension. There are multiple therapeutic interventions for both acute episodes and to prevent recurrence once the possible trigger is identified and the cardiovascular risk of the affected patient is stratified, and with timely intervention a positive impact can be achieved not only on the mortality of the event, but also on quality of life and years of productive life. A 41-year-old man with no relevant medical history suffered a sudden episode of loss of consciousness and postural tone, followed by tonic-clonic seizures lasting 3 minutes, with deviation of the labial commissure to the left. She regained full consciousness after the episode, but experienced amnesia of the event. After 4 days of hospitalization, she was discharged with secondary prevention with acetylsalicylic acid.
References
Easton JD, Johnston SC. Time to Retire the Concept of Transient Ischemic Attack. JAMA. 2022 Mar 1;327(9):813-814. https://doi.org/10.1001/jama.2022.0300
Campbell, B. C. V., De Silva, D. A., Macleod, M. R., Coutts, S. B., Schwamm, L. H., Davis, S. M., & Donnan, G. A. Ischaemic stroke. Nature Reviews. Disease Primers. 2019; 5(1), 1–22. https://doi.org/10.1038/s41572-019-0118-8
Sacco, R. L., Kasner, S. E., Broderick, J. P., Caplan, L. R., Connors, J. J. (buddy), Culebras, A., Elkind, M. S. V., George, M. G., Hamdan, A. D., Higashida, R. T., Hoh, B. L., Janis, L. S., Kase, C. S., Kleindorfer, D. O., Lee, J.-M., Moseley, M. E., Peterson, E. D., Turan, T. N., Valderrama, A. L., & Vinters, H. V. An updated definition of stroke for the 21st century: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke; a Journal of Cerebral Circulation. 2013; 44(7), 2064–2089. https://doi.org/10.1161/str.0b013e318296aeca
Easton, J. D., & Johnston, S. C. (2022). The concept of transient ischemic attack—reply. JAMA: The Journal of the American Medical Association. 327(24), 2457. https://doi.org/10.1001/jama.2022.7630
Vilela, P. Acute stroke differential diagnosis: Stroke mimics. Eur J Radiol. 2017; 96, 133–144. https://doi.org/10.1016/j.ejrad.2017.05.008
Ekker, M. S., Verhoeven, J. I., Vaartjes, I., van Nieuwenhuizen, K. M., Klijn, C. J. M., & de Leeuw, F.-E. Stroke incidence in young adults according to age, subtype, sex, and time trends. Neurology. 2019; 92(21). https://doi.org/10.1212/wnl.0000000000007533
Hacke, W., Kaste, M., Bluhmki, E., Brozman, M., Dávalos, A., Guidetti, D., Larrue, V., Lees, K. R., Medeghri, Z., Machnig, T., Schneider, D., von Kummer, R., Wahlgren, N., & Toni, D. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med. 2008; 359(13), 1317–1329. https://doi.org/10.1056/nejmoa0804656
O’Donnell, M. J., Chin, S. L., Rangarajan, S., Xavier, D., Liu, L., Zhang, H., Rao-Melacini, P., Zhang, X., Pais, P., Agapay, S., Lopez-Jaramillo, P., Damasceno, A., Langhorne, P., McQueen, M. J., Rosengren, A., Dehghan, M., Hankey, G. J., Dans, A. L., Elsayed, A., … Yusuf, S. (2016). Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. Lancet, 388(10046), 761–775. https://doi.org/10.1016/s0140-6736(16)30506-2
Downloads
Published
Issue
Section
License
Copyright (c) 2023 David Fernando Ortiz Pérez, John Sebastián Osorio Muñoz, Manuel Esteban Ortiz Pérez
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
