"The patient is 29 years old this year, delirious, appearing aphasia and right limb movement and other symptoms, emergency brain CT to exclude cerebral hemorrhage, urgent investigation of cranial magnetic resonance, notify the neurointerventor Lin Lei for consultation, be fast!"
"Magnetic resonance suggests large-scale cerebral infarction, immediately start the interventional thrombotomy process, and prepare the catheter room!"
Dr. Lin Lei had sufficient preoperative communication with the patient's family and obtained consent to decide to urgently implement the interventional thrombotomy, and at the same time, the medical team of the catheterization room had completed the preoperative preparation early. Cerebral angiography confirms the patient's left internal carotid artery dissection, resulting in carotid artery occlusion and left middle cerebral artery branch occlusion, the situation can be described as serious and dangerous.
There is no room for time to waste, "Surgery now!" Surgeon Lin Lei immediately decided to take "percutaneous intracranial artery embolectomy + carotid artery stent implantation" for the patient. After tacit cooperation with the doctor Ma Chao, after two and a half hours, the patient turned the crisis on the operating table, the occlusive blood vessels were completely opened, and the paralyzed limbs after the operation improved immediately, and after nearly five days of hospitalization, the muscle strength of the limbs was further restored, and he could walk and talk independently, and he could be discharged after 5 days.
Preoperative and postoperative
"Two days before the onset of the disease, he said he had some headaches, but he didn't pay much attention." According to the patient's family recollection, when he got up at about 5 a.m. on the same day, he just walked two steps and sat on the ground due to limb weakness, and there were symptoms of mental trance and poor movement of the right limb, and after resting for more than ten minutes, he found that he could not relieve himself, so he immediately called the emergency telephone of Jinxiang County People's Hospital.
"Worldwide, the incidence of stroke in the elderly is declining, but in the last decade, the incidence of stroke in youth has increased by 40%. The age of first onset of stroke in China as a whole is 10 years lower than the average in Europe and the United States, and the prevalence of stroke in young people is obvious. "After surgery, Physician Lin Lei said that arterial dissection is a common cause of young stroke patients, and the treatment mode of acute stage of youth stroke is the same as that of middle-aged and elderly stroke, including intravenous thrombolysis, arterial embolization, etc. Several retrospective studies in arterial embolization have shown that youth stroke embolization may have a higher recanalization rate and good prognosis, and fewer complications.
Health knowledge
Stroke
Western medicine is called cerebrovascular accident, and Chinese medicine is called cerebral stroke. It is a type of disease characterized by sudden fainting, with crooked corners of the mouth, poor language, hemiplegia, or sudden half-body failure without fainting. Including cerebral hemorrhage, cerebral infarction, transient ischemic attacks, etc. It is urgent, fierce, early warning, and easy to ignore. In the continent with an aging population, it is mainly ranked first in the causes of death of mainland residents due to the "three highs" of high morbidity, high mortality and high disability rate.
Cause of stroke
Uncontrollable: age, ethnicity, genetic factors, etc.
Controllable: hypertension, arteriosclerosis, diabetes, coronary heart disease, atrial fibrillation, smoking, alcohol consumption, etc.
Youth stroke
The overall clinical picture is not different from stroke of other ages, but has its characteristics:
1. Stroke-like symptoms are not necessarily stroke
For example, migraine, epilepsy, etc. are common diseases in young people, and may be accompanied by transient acute focal symptoms.
2. Stroke presents as atypical symptoms
Symptoms such as headache and fever before or at the onset of the disease, stroke symptoms are easily ignored.
3. Other characteristics
Some have clear triggers, such as trauma, special actions, medication, etc.
Time is of the essence
Time is the key to saving brain cells. Patients are best treated effectively within 3-6 hours of onset. Once the disease occurs, the patient's family or friend should urgently dial 120, as soon as possible to the nearest stroke center and other hospitals with arteriovenous thrombolysis and thrombolysis conditions, do not drive the patient to the hospital, so as to avoid accidental helplessness on the road, delay the timing of treatment. Evidence suggests that the shorter the interval between onset and effective treatment for acute cerebral infarction, the better the efficacy of thrombolysis or interventional thrombolysis, and the lower the disability and mortality rates.
Source: Jinxiang County People's Hospital