Patient Saved From Detrimental Effects of Cerebral Hemorrhagic Stroke09/06/2022
Hoan My Cuu Long Hospital successfully recovers a patient from cerebral hemorrhagic stroke by timely activation of “Code Stroke” within “golden hour”.
Mrs. C.T.N (62 years old, resident of Vinh Long province) fainted at home at 14:00 on the day of admission, was found by her family and quickly taken to Hoan My Cuu Long Hospital. According to the patient’s family, she has a history of essential hypertension.
Upon admission, on-call physicians discovered signs of acute stroke in the patient and quickly activated Code Stroke (an emergency protocol for treating stroke patients). The patient was immediately sent for a cerebral MSCT, which showed a subarachnoid hemorrhage due to an anterior communicating artery abruption of 4.5mm. The Code team was able to access the abruption of the cerebral aneurysm, which was worsening over time and had the potential to be life-threatening. They opted to block the aneurysm with a metallic coil, assisted by Digital Subtraction Angiography (DSA). A small catheter was inserted from the femoral artery into the broken cerebral artery, and it was embolized with a coil, using DSA.
The intervention took approximately one hour. One day later, the patient was taken off mechanical ventilation and doctors were able to remove the endotracheal tube. The patient’s condition had improved almost fully; she was awake, her paralysis was gone, and she was transferred to an inpatient area for monitoring, before being discharged for outpatient monitoring.
First-degree specialist, MD. Nguyen Huu Thai, Chief of Endovascular Surgery, Cardiology Department, Hoan My Cuu Long Hospital, explained: “A stroke is dangerous if not treated promptly. It can cause severe neurological sequelae and possibly death. This patient had a subarachnoid hemorrhagic stroke, which is bleeding in the space between the brain and its surrounding membranes. The current main treatment is a cerebral vascular intervention with a metallic coil, an approved medical advancement that has replaced open cerebral surgery with vascular clamping. With many outstanding advantages, it helps in the swift removal of a brain aneurysm. The patient feels less pain, the hospital stay can be shorter, and the danger of stroke is reduced.
First-degree specialist, MD. Do Van Pham, Chief of Intensive Care Unit (ICU), also commented: “The amount of time between when the first signs of a stroke appear, and intervention, is crucial. This is called the “golden hour” and it can determine whether the case is life or death, as well as minimising brain injuries. The “golden hour” or period for a cerebral stroke is actually less than three hours. At Hoan My Cuu Long hospital, when admitting stroke patients, Code Stroke – an emergency protocol for stroke patients – is activated immediately. The Code team consists of five doctors who are all well-trained in their specialisms for fast and efficient emergency response, aiming to treat a stroke patient within their “golden hour,” which is less than 60 minutes after arriving at the Emergency Room.
Hoan My Cuu Long Hospital has successfully performed interventions for many stroke patients. It is, however,possible to mitigate the risk of a stroke. Good control of blood pressure and properly treating hypertension are the most significant factors in preventing a stroke. Besides these, it is vital to determine the etiology of a brain hemorrhage, such as diagnosing aneurysms and varicose veins and treating them. Time is of the essence for effective and cost-effective stroke control, ensuring emergency treatment and stroke care during the “golden hour”. If patients exhibit any indicators of a suspected stroke, they should seek treatment and diagnosis at the nearest specialist stroke centre as soon as possible.