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A Stroke of Bad Luck: An Autobiographical Case Report.
1Dermatology, University of California Davis Medical Center, Sacramento, USA.
Cureus
|October 9, 2023
Summary
This case study highlights a stroke patient who experienced isolated dysarthria due to atrial flutter. Early anticoagulation and speech therapy led to significant speech improvement, emphasizing prompt stroke management.
Area of Science:
- Neurology
- Cardiology
Background:
- Cardiovascular diseases like atrial fibrillation and atrial flutter are significant risk factors for ischemic strokes.
- Ischemic strokes can manifest with various neurological deficits, including dysarthria.
Observation:
- A 64-year-old man presented with isolated dysarthria, diagnosed as an ischemic stroke caused by middle cerebral artery occlusion.
- The patient was found to have atrial flutter, identified as the probable cause of the stroke.
Findings:
- The patient received initial heparin anticoagulation, followed by apixaban as a direct oral anticoagulant.
- Medical conversion to normal sinus rhythm was achieved with amiodarone, with atrial flutter ablation planned.
- Significant improvement in dysarthria was observed within 24 hours, with continued progress after five weeks of speech therapy.
Implications:
- This case underscores the importance of considering atrial flutter as a stroke etiology, even with isolated dysarthria.
- Prompt anticoagulation and targeted speech therapy are crucial for managing post-stroke dysarthria and improving patient outcomes.
- Direct oral anticoagulants offer a favorable safety profile for stroke prevention in nonvalvular atrial fibrillation.
Keywords:
accidentatrialcerebrovascularcomputer axial tomographycortexdysarthriafibrillationfluttermagnetic resonance imagingstrokeMore Related Videos
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