🚨Acute #stroke case (from the archive):
Patient in 60s presents with sudden onset fluctuating LOC, dysarthria, mild right arm weakness (disabling)
Last seen normal 2hrs (witnessed onset).
You urgently take to CT- motion artifact, no clear early ischemic changes. CTA normal.
Patient in 60s presents with sudden onset fluctuating LOC, dysarthria, mild right arm weakness (disabling)
Last seen normal 2hrs (witnessed onset).
You urgently take to CT- motion artifact, no clear early ischemic changes. CTA normal.
2 schools of thought/approaches:
Approach #1⃣: Acute onset, disabling symptoms- proceed with lytic 💉and defer CTP
Approach #2⃣: Dx is still a bit unclear (ddx: seizure⚡️, etc)- proceed to CTP
If in camp #2, here are the CTP maps (CBF, MTT, Tmax>8s)
Approach #1⃣: Acute onset, disabling symptoms- proceed with lytic 💉and defer CTP
Approach #2⃣: Dx is still a bit unclear (ddx: seizure⚡️, etc)- proceed to CTP
If in camp #2, here are the CTP maps (CBF, MTT, Tmax>8s)
CTP confirms suspected localization of left thalamus (with possible internal capsule involvement).
CTP helped confirm the etiology (not a mimic), but delayed lytic administration by about 7-10 min (did not change management).
Which camp/approach are you in for this case🧠?
CTP helped confirm the etiology (not a mimic), but delayed lytic administration by about 7-10 min (did not change management).
Which camp/approach are you in for this case🧠?
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