Acute Ischemic Stroke with Planned Thrombectomy in 60-Year-Old Male

Case at a Glance

A 60-year-old male presents with acute ischemic stroke affecting the right hemisphere, manifesting with aphasia and requiring emergency mechanical thrombectomy for clot removal.

Patient's Story

The patient experienced sudden onset neurological symptoms consistent with acute stroke. Family members noted difficulty with speech and language comprehension. Emergency medical services were contacted and the patient was transported to a stroke center for evaluation and treatment.

Initial Assessment

Upon presentation, the patient demonstrated clear signs of aphasia, suggesting involvement of language centers typically associated with left hemisphere or dominant hemisphere involvement. Initial stroke severity assessment yielded a score of 5, though the specific scoring system used requires clarification between NIHSS (National Institutes of Health Stroke Scale) or ICH (Intracerebral Hemorrhage) score.

The Diagnostic Journey

Neuroimaging confirmed the presence of a large vessel occlusion requiring immediate intervention. The stroke appeared to primarily affect the right side of the brain, though this seemed inconsistent with the aphasia presentation, suggesting possible bilateral involvement or dominant hemisphere affect. The medical team determined that mechanical thrombectomy was indicated for clot removal.

Final Diagnosis

Acute ischemic stroke with large vessel occlusion, candidate for mechanical thrombectomy. The exact vessel involved and complete neurological deficits require further documentation.

Treatment Plan

Emergency mechanical thrombectomy procedure scheduled for clot removal. This endovascular intervention aims to restore blood flow to the affected brain tissue and minimize long-term neurological damage. Post-procedural monitoring and rehabilitation planning will be essential components of care.

Outcome and Follow-up

Prognosis remains guarded pending completion of the thrombectomy procedure and depends heavily on time from symptom onset, extent of brain tissue affected, and success of recanalization. Long-term outcomes will require comprehensive neurological assessment and may include speech therapy for aphasia, physical therapy, and ongoing stroke prevention measures. Family communication regarding medical information and prognosis discussions with the treating medical team are recommended for optimal care coordination.