RESUMEN
The authors reported a case with acute right, middle cerebral artery infarct in which the early infarct area was detected by CTP recovery later after the treatment. The patient had hypoxia and tachypnea from pulmonary edema during acute ischemic stroke, which may have accentuated the ischemic change in cerebral hemodynamic. With treatment, the causes of hypoxia were corrected and the patient got better and some parts ofthe brain, previously identified as infarct, turned out to be normal.
Asunto(s)
Errores Diagnósticos , Infarto de la Arteria Cerebral Media/diagnóstico por imagen , Imagen de Perfusión , Tomografía Computarizada por Rayos X , Humanos , Hipoxia/complicaciones , Infarto de la Arteria Cerebral Media/complicaciones , Infarto de la Arteria Cerebral Media/diagnóstico , Masculino , Persona de Mediana Edad , Edema Pulmonar/complicaciones , Recuperación de la Función , Índice de Severidad de la EnfermedadRESUMEN
OBJECTIVE: Transthoracic echocardiography (TTE) is routinely performed to look for the cardiac sources of emboli in many Western stroke centers. Due to a limitation of resources in Thailand, echocardiography is done in only some patients with acute ischemic stroke. The purpose of this study is to evaluate the need for cardiac investigations, especially TTE, in Thai patients with acute ischemic stroke. MATERIAL AND METHOD: Two-hundred and seven patients with acute ischemic stroke or transient ischemic attack (TIA), who had TTE results during August 2006 to November 2008, were studied. Patients were divided into 2 groups by the risk of cardioembolism: low- versus high-risk groups. All echocardiography results were reviewed and classified by the need for management change following the echocardiography. RESULTS: Abnormal TTE results indicating a need for change in management were found in 4% (4/102) and 18% (18/105) in low- and high- risk patients, respectively The results of ECG alone led to change in management in 17% (36 patients). Atrial fibrillation was the most common cause of cardioembolism, which was found in 35 patients (17%). CONCLUSION: Because of limited resources in Thailand, ECG should be routinely performed on all ischemic stroke patients and TTE in patients with high risk for cardioembolism. However larger studies are still needed to clarify the benefits of echocardiography in low-risk patients.