Vinmec Da Nang has successfully treated a patient who experienced a brain stroke case on Ly Son island district, which is more than 150km from the hospital. The patient was taken to emergency within the "golden" time and has since recovered fully without experiencing any complications.
Overcoming 2 long-distance routs, the strock patient was still taken to emergency within the "golden time"
On the morning of June 21, 2020, when Vinmec Danang Hospital received information that Ms. Dao Thi Hoa - the patient, while traveling on Ly Son island, suffered from a stroke. Upon receiving the message, the stroke emergency and cerebral vascular intervention team immediately activated the emergency process and was ready to receive the patient so as not to miss the patient's "golden" time (within 4.5 hours from the onset of the stroke). After 4 hours of traveling through two routes from Ly Son island, Ms. Hoa was taken to Vinmec Da Nang in a state of lethargy, inability to speak, lopsided mouth to the right, and complete right hemiplegia.
From the results of clinical examination and modern imaging tests (CT/MRI/MRA), Ms. Hoa was diagnosed with fulminant cerebral infarction due to complete occlusion of the middle cerebral artery on the left. This is a very serious disease with a high risk of death and disability. The team of leading stroke experts in the central region, including Dr. Nguyen Thai Tri, Head of Emergency Department, and Dr. Ton That Tri Dung (Ph.D, MD), Head of Medical Examination and Internal Medicine, Vinmec Danang Hospital, said that it was critical to take immediate measures to revascularize and reperfuse the patient's brain. Afterward, wasting no time, the team promptly performed 2 emergency techniques of dissolving blood clots with drugs and intervening to remove the blood clots through the arteries.
As a result, the patient's blood vessels were completely reopened 40 minutes after admission, which was less than 6 hours since the onset of the stroke. Immediately after the intervention, the patient's condition started improving remarkedly. Ms. Hoa was then able to move her right limbs well, stay awake, spoke, and answered questions correctly, though with some difficulty in pronunciation. In the following days, with intensive care, the patient's condition continued to improve and she was able to get up and walk on her own with minimal support. In the middle of July 2020, Ms. Hoa was discharged from the hospital in stable condition and doctors assessed that she had absolutely no complications.
Early stroke detection using the 'FAST' method
This is a miracle in the record of saving patients with acute stroke by Vinmec Danang International General Hospital. To achieve this success, besides the efforts of the stroke intervention emergency team in the evaluation, diagnosis, and implementation of modern stroke emergency techniques, there was also prompt response and coordination by the patient's family members.
“The family understood the danger of a brain stroke and the importance of early first aid. So, they quickly mobilized all resources to bring the patient to the hospital, without wasting time on commonly-seen ineffective methods such as acupressure and coining. After a stroke, nearly 2 million brain cells die every minute, so delay in taking patients into emergency can lead to lifelong disability or even death," said Dr. Ton That Tri Dung.
According to doctors at Vinmec Da Nang, stroke can be recognized early by following the FAST method as illustrated below. Three following symptoms are among signs of a high probability of stroke: sudden weakness, paralysis of the arms/legs, lopsided mouth, and sudden speech difficulties or inability to speak.
The focus of stroke treatment is to revascularize clogged vessels as soon as possible with Recombinant Tisue Plasminogen Activator (rTPA) for patients who arrive at the emergency less than 4.5 hours after the onset of the stroke and thrombectomy using a mechanical device for patients who arrive less than 6 hours since the onset. In 2018, the American Stroke Association recommended mechanical thrombectomy in patients with large vessel occlusion in the brain who arrive late (6-24 hours after the onset). However, such patients must first be evaluated through the results of their CT Perfusion (CTP) scan. This is a technique that can only be performed by multi-sequence CT scanners with the support of specialized software. To meet the increasing need for stroke treatment, Vinmec Danang International Hospital is now equipped with a modern CT and MRI system (3.0 Tesla MRI system) and a lot of other advanced equipment to bring about the best treatment results.
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