Case 3: 68yr M, just finished eating. Found by wife collapsed, with right sided weakness, dysphasia. Onset 12:40, seen13:40. NIHSS 31 Mute, force deviation, hemianopia, dense right sided weakness, inattention. Now it is 2hr 15mins.

Vocal cord squamous cell ca, resected sep 20, under follow up

Independent

BP146/68

 

CT head

You go onto review the CT Head below.

 
 
 

You also want to see the CTA

 
 
 

CTA AI Interpretation

 
 
 

CT Perfusion

You may wish to review the AI output for the CT Perfusion which on this occasion has been performed.

 
 
 

Radiology review

If you feel you need radiology review prior to further decision making, feel free to watch the video below. If you are happy making a decision based on the imaging you have reviewed please continue past this section and review it at the end of the scenario for educational purposes.

 
 

Decision time:

Do you recommend the referring clinician begin thrombolysis? (Stroke Physicians Only)

Does the patient meet the criteria for thrombectomy? (for all clinicians)

Reminder of the criteria

  1. NIHSS greater than 5 or aphasia.

  2. ICA or M1 occlusion

  3. MRS 0-2

If none of the above what would you recommend the referring clinician do? (Stroke Physicians only)

 

INR Referral

If you did refer to the INR this is what they would have said to you.

 
 
 

Conclusion

See feedback below from an experienced fellow stroke physician for their opinion on what they would have done..