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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

  • Ochiai Hidenobu
    Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Miyazaki, Japan
  • Kanemaru Katsuhiro
    Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Miyazaki, Japan
  • Matsuda Shuntaro
    Department of Internal Medicine, Kushima Municipal Hospital, Japan
  • Ohta Hajime
    Department of Neurosurgery, Faculty of Medicine, University of Miyazaki, Japan

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Abstract

<p>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.</p><p>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.</p><p>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.</p><p>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.</p>

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