On June 12, Hue University of Medicine and Pharmacy Hospital said that the hospital's Stroke Emergency Center had just successfully treated a case of concurrent cardio-cervical infarction (CCCI), a rare disease with a high risk of death.
The male patient, 56 years old, was hospitalized after waking up with symptoms of paralysis of the right half of his body, difficulty speaking, central facial paralysis. Through examination, the patient was completely paralyzed in the right half of his body, Wernicke-style speechlessness, NIHSS score 8 and Glasgow score 14.
The results of CT scans of the skull and cerebral blood vessels showed that the patient had cerebral infarction in the left coronary region due to complete blockage of the left internal carotid artery, accompanied by a stenosis of 60% of the right internal carotid artery.
In the process of preparing for intervention, the family provided additional information that the patient had had chest tightness symptoms from the previous afternoon. Although the electrocardiogram did not detect clear signs, the heart enzyme test showed acute myocardial damage.
Doctors determined that the patient had acute cerebral infarction due to blockage of the left internal carotid artery accompanied by acute myocardial infarction and immediately activated the coordination procedure between the interventional cardiovascular team and the interventional stroke.
Coronary angiography results showed that the patient had a stenosis of 90% of the right coronary artery and 80% of the cape branch. The cardiovascular team successfully placed a stent in the right coronary artery in about 17 minutes. Immediately after that, doctors continued to remove the cerebral artery blood clot using Solumbra technique.
During the intervention, doctors discovered another severe stenosis at the base of the left internal carotid artery and performed emergency stent placement. After the procedure, the blood vessels were completely re-circulated.
After only about 4 hours, the patient's neurological condition improved significantly. The strength of the right limbs increased from 1/5 to 4/5, the patient spoke and performed well the doctor's requests.
According to Assoc. Prof. Dr. Nguyen Dinh Toan - Director of the General Emergency and Stroke Center, Hue University of Medicine and Pharmacy Hospital, cerebral and cardiac infarction is also a very rare condition, the reported incidence is only from 0.009 - 0.9%, while the hospital-acquired mortality rate can be up to 23 - 41%.
Treatment for this group of patients faces many challenges because both cerebral infarction and myocardial infarction need to be treated urgently, but there are currently no specialized treatment guidelines on optimal strategies.
The above case shows the important role of multidisciplinary coordination between stroke emergency, interventional cardiology, anesthesia and resuscitation, and diagnostic imaging. Timely intervention has helped save the patient's life, while opening up opportunities for better neurological function recovery after a particularly dangerous medical situation.
