Man Saved from Future High-Risk Stroke with Timely Accurate Diagnosis and Intervention
Manokurian Mathew, aged 40 visited Zulekha Hospital Dubai with non-specific complaints like difficulty in sleeping, anxiety headaches and recent onset of memory loss. Dr. Shyam Babu Chandran, Consultant Neurologist advised for imaging of the brain to be done to diagnose the recent onset of memory issues in this young man. It was found that Manokurian had two infarctions on his left side of brain (damage of brain tissue due to lack of blood supply which were unknown to him, and he had assumed his right arm weakness was just a casual symptom of exhaustion and poor sleep posture. His weakness had gone away after a few hours on both occasions, so he had not taken the episodes seriously.
Brain strokes are common in smokers and individuals with unidentified diabetes, hypertension and people with high cholesterol in addition to many other genetic conditions. In his case, the left internal carotid artery supplying to the brain had narrowed with a 70% stenosis due to the excess cholesterol deposits. Dr. Shyam explains, “Being a diabetic and a smoker has increased his risk of these infarctions. The two instances of right hand numbness experienced by him were a result of the repeated internal clotting that probably has formed and migrated from the left carotid plaque and impacted the nervous system. In such cases it is very important to thoroughly evaluate and plan potential treatment to prevent future high-risk strokes.”
A multidisciplinary team of Neurology and Neuroradiology investigated and carried out the quick procedure of CAS (carotid angioplasty and stenting).
Dr. Chinmay Pankajkumar Shah, Interventional Radiology & Neuroradiology supported the procedure. As the Neurologist Dr. Shyam identified the problem, evaluated it thoroughly, making sure the patient is a right candidate for an angioplasty, giving the right medications, and took care of preparations prior to the procedure to avoid any risks of stokes during the procedure.
He adds, “We chose to perform an angioplasty of the left carotid artery with stenting. The two hour long procedure was done through a minimal invasive puncture in the femoral artery. Closely monitoring the patient after the procedure is very critical as there are chances of a sudden rush of blood through the cleared arteries that could cause a sudden stroke in the form of bleeding in addition to slowing of heart rate and low blood pressure. Further, the blood pressure of the patient needs to be well monitored and controlled during and after the procedure as well.”
Manokurian states, “It is great that Dr. Shyam was able to diagnose the hidden danger in left carotid artery and treat me correctly in time. I was just assuming it could be only sinusitis or migraine. If the infarctions were unidentified, my career and entire life would have been in danger. I am thankful for a new lease of life given to me. This is important and I would advise anyone who has any unusual symptoms to immediately get yourself checked by a professional.”
The team of experts has been successful in reviving Manokurian and wiped out the potential risk of a stroke if he hadn’t visited the neurology clinic. He was discharged the very next day in a stable state.