CASE OF THE WEEK – “Stroke in young” by Dr. Mohammed Shabbir, Specialist, Emergency Medicine, Dr. Bobby Jose, HOD & Specialist, Neurosurgery & Clinical Administrator and Dr. Rupesh Singh, Specialist, Interventional Cardiology at NMC Royal Hospital Sharjah

Introduction

Strokes in young adults are reported as being uncommon, comprising 10%–15% of all stroke patients. However, compared with stroke in older adults, stroke in the young has a disproportionately large economic impact by leaving victims disabled before their most productive years. Recent publications report an increased incidence of stroke in young adults. This is important given the fact that younger stroke patients have a clearly increased risk of death compared with the general population. The prevalence of standard modifiable vascular risk factors in young stroke patients is different from that in older patients. Modifiable risk factors for stroke, such as dyslipidemia, smoking, and hypertension, are highly prevalent in the young stroke population, with no significant difference in geographic, climatic, nutritional, lifestyle, or genetic diversity. The other most important risk factor is cardioembolic causes mainly cardiac arrhythmia and infective endocarditis.

Case report

A 32 year old Female patient was brought to ER at 11 am with the H/O right sided weakness from morning 9am. Patient was evaluated in ER found to have Atrial Fibrillation, CT brain with angio done which showed left MCA occlusion. Neurosurgeon was alerted immediately, Patient shifted to cathlab. Left MCA clot removed and patient recovered completely without any residual neurological deficit.

Conclusion

Stroke management needs a coordinated timely multidisciplinary (Emergency, Neurosurgery and Cardiology) team approach to have best outcome like in this Patient. One should always remember “TIME IS BRAIN” in STOKE Patients