Case Study:
Nearing the end of your day shift in a community hospital emergency department (ED), a 71-year-old male is brought in by his wife who says that while signing the receipt for their meal, her husband suddenly had difficulty writing, dropped his pen from his right hand, had a right facial droop, and had “garbled” speech. The patient’s wife says the symptoms resolved completely after approximately 10 minutes. Now, approximately 60 minutes later in the ED, the patient appears well, has normal vital signs, and a normal neurologic examination. He says he feels fine and wants to go home. The patient’s wife says that although her husband has a history of high blood pressure, he has always been otherwise healthy, but she is very concerned about him. She has never seen him like that before and asks what needs to be done for her husband after almost having a stroke.
Case Study Conclusion:
Your 71-year-old male patient with a history of hyper¬tension presented to the ED with 10 minutes of right arm weakness, right facial droop, and garbled speech. It was clear to you that he was at high risk of having as stroke within the 48 hours following presentation. When applying the clinical prediction rules, his score was 5, which placed him in the high/intermediate risk group. This indicated that his risk of stroke within the next 2 days was approximately 5% and would rise to nearly 10% by 7 days from presentation. Thus, this patient highly benefited from immediate evaluation and intervention in your hospital.
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