A case of acute cerebral infarction with a favorable prognosis after rt-PA administration by a general physician with telestroke support

Hidenobu OCHIAI; Katsuhiro KANEMARU; Shuntaro MATSUDA; Hajime OHTA

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A case of acute cerebral infarction with a favorable prognosis after rt-PA administration by a general physician with telestroke support

VernacularTitle:A case of acute cerebral infarction with a favorable prognosis after rt-PA administration by a general physician with telestroke support
Author: Hidenobu OCHIAI ¹ ; Katsuhiro KANEMARU ¹ ; Shuntaro MATSUDA ² ; Hajime OHTA ³
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1. Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Miyazaki, Japan
2. Department of Internal Medicine, Kushima Municipal Hospital, Japan
3. Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, Japan
Keywords: acute cerebral infarction; rt-PA therapy; neuroprognosis; telestroke; general physician
From:Journal of Rural Medicine 2021;16(2):119-122
CountryJapan
Language:English
Abstract: Objective: Herein, we report a patient with acute cerebral infarction with a favorable prognosis after being managed by a general physician with support from the telestroke program.Patient and Methods: An 85-year-old man was transferred to a regional hospital due to sudden onset of dysarthria and left hemiparesis. As no neurosurgeons or neurologists were available in that hospital or area, the patient was examined by a general physician who diagnosed him with cardioembolic stroke on the left middle cerebral artery territory. The physician consulted a stroke specialist using the telestroke system; with the support from the telestroke program, the physician administered thrombolytic therapy 4 hours and 10 minutes after the onset of symptoms.Results: The patient’s National Institutes of Health Stroke Scale score improved from 9 to 3 and he was subsequently transferred to the stroke center. However, the occluded left middle cerebral artery had already re-canalized. His hemiparesis completely improved one week after the onset.Conclusion: A telemedicine system for general physicians is indispensable in areas without accessible stroke specialists as it provides access to a standard of care for hyper-acute stroke patient assessment and management, and helps improve neuroprognosis.