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Urgent intervention to reduce functional deficits after postoperative stroke.
Andrew W Lee1, Cameron Davis, H Adrian Puttgen
1Department of Neurology, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Phipps 126, Baltimore, MD 21287, USA. alee74@jhmi.edu
Nature Clinical Practice. Neurology
|March 8, 2007
Summary
A patient experienced sudden aphasia due to a stroke affecting Broca's area. Prompt saline-induced hypertension successfully restored blood flow, resolving speech deficits and highlighting the value of perfusion imaging.
Area of Science:
- Neurology
- Neuroimaging
Background:
- A 67-year-old male with atrial fibrillation presented with acute aphasia post-urological surgery.
- Initial MRI revealed hypoperfusion in Broca's area with minimal infarction.
Observation:
- Neurological examination, language testing, and advanced MRI (diffusion- and perfusion-weighted) were performed.
- Diagnosis was acute cardioembolic stroke impacting Broca's area and surrounding hypoperfused cortex.
Findings:
- Saline-induced hypertension led to rapid restoration of cortical perfusion.
- Complete resolution of speech and language deficits was observed.
Implications:
- Perfusion-weighted imaging is crucial for identifying stroke patients eligible for urgent intervention when thrombolysis is contraindicated.
- This case underscores the potential for rapid recovery with timely reperfusion strategies in selected stroke cases.
