Case Report
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Talihsiz Bir Birliktelik, Direksiyon Başında İskemik İnme. Ne Kadar Sık? Ne Kadar Ölümcül? Bir Olgu Sunumu

Year 2020, Volume: 3 Issue: 3, 85 - 88, 30.09.2020

Abstract

Amaç: Trafik kazası nedeni ile acil servisimize 112 ekiplerince getirilen, tıbbi değerlendirme neticesinde iskemik inme tanısı koyduğumuz bir vakayı sunmayı amaçladık.

Olgu Sunumu: 57 yaşında erkek hasta, trafik kazası nedeniyle ambulansla acil servise getirildi. GKS (glasgow koma skalası) skoru 11 olarak hesaplandı. Sağ santral fasiyal paralizisi olan hastanın sağ üst ve alt ekstremitelerinde neredeyse tamamen güç kaybı vardı. Kontrastsız bilgisayarlı beyin tomografisinde (BT) akut patoloji saptanmadı. Serebral anjio-tomografisinde sol orta serebral arter M1 seviyesinde yaklaşık 5 mm lik segmentte ılımlı lümen daralması oluşturan aterom plağı ile uyumlu olabilecek değişimler izlenmekte idi. İskemik inme tanısı alan hasta nöroloji ile konsülte edildi, trombektomi endikasyonu için girişimsel radyoloji konsültasyonu istendi. Başarılı bir rekanalizasyondan sonra nöroloji yoğun bakım ünitesine (YBÜ) kabul edildi. Acil servise başvurusundan 96 saat sonra Glasgow Koma Skalası (GKS) skoru 15, duyu ve motor defisitlerinde tam düşüş ve afazide kısmi düzelme ile taburcu edildi. Daha sonra nöroloji polikliniğine kontrole çağırıldı.

Sonuç: İnme ve trafik kazaları, dünya çapında önemli sağlık sorunları arasında kabul edilmektedir. Trafik kazaları ile ilişkili sağlık sorunları çoğunlukla travmanın birincil ve ikincil etkilerinden kaynaklansa da, kazaların tıbbi durumlar sonucunda ortaya çıkabileceği akılda tutulmalıdır.

References

  • Benjamin EJ, Muntner P, Alonso A et al. American Heart Association. The heart disease and stroke statistics. Circulation. 2019;139:447-54. Doi: 10.1161/CIR.0000000000000659.
  • Kolbaş F, Akça HŞ, Özdemir S et al. Ischemic stroke after head trauma in a child: case report, Int J Med Rev Case Rep. 2020; 4(4): 132-134. doi:10.5455/IJMRCR.IschemicStrokeheadtraumachildcasereport
  • Inoue T, Hitosugi M, Ooba H et al. Rate of stroke onset while driving and subsequent collision. J Stroke Cerebrovasc Dis.2018;27(9):2553-4. Doi:10.1016/j.jstrokecerebrovasdis.2018.04.029.
  • Inamasu J, Nakatsukasa M, Tomiyasu K et al. Stroke while driving: Frequency and association with automobile accidents. Int J Stroke. 2018;13(3):301-7. Doi: 10.1177/1747493017728398.
  • Büttner A, Heimpel M, Eisenmenger W. Sudden natural death 'at the wheel': a retrospective study over a 15-year time period (1982-1996). Forensic Sci Int 1999;103(2):101-12. Doi: 10.1016/s0379-0738(99)00063-8.
  • Varlık M, Eroğlu S, Özdemir S et al. Evaluation of patients who applied to the emergency department by Intra-Vehicle Traffic Accident. Fırat Med.Journal 2019;24(4):186-92.
  • Özdemir S, Ocal O, Aksel G et al. Evaluation of rhabdomyolysis patients who opted for emergency services, North Clin Istanb 2017;4(3):257-261. doi: 10.14744/nci.2017.85619.
  • Tervo T, Räty E, Sulander P et al.Sudden death at the wheel due to a disease attack. Traffic Inj Prev 2013;14(2):138-44. Doi: 10.1080/15389588.2012.695827.
  • Brodie LR, Odell M, Ranson D et al. Sudden natural death behind the wheel: Review of driver deaths and fitness to drive assessment history in Victoria, Australia 2012-2013 J Forensic Leg Med 2019;63:31-3. Doi: 10.1016/j.jflm.2019.02.011.

An Unfortunate Coexistence, Ischemic Stroke While Driving. How Often? How Deadly? A Case Report

Year 2020, Volume: 3 Issue: 3, 85 - 88, 30.09.2020

Abstract

Aim: We aimed to present a case brought to our emergency department by 112 teams due to a traffic accident and diagnosed with ischemic stroke as a result of medical evaluation.

Case Report : A 57-year-old male patient was brought to the emergency room by ambulance due to a traffic accident. The Glasgow Coma Scale (GCS) score was calculated 11. The patient with right central facial paralysis had almost complete loss of strength in the right upper and lower extremities. Acute pathology was not detected in non-contrast Computerized tomography (CT). Anjio tomography was reported as the changes that are compatible with the atheroma plaque which creates a moderate luminal narrowing are seen within approximately 5 mm segment at M1 level of the left middle cerebral artery. The patient who was diagnosed with ischemic stroke was consulted to the neurologist, latter interventional radiology consultation was requested for the indication of thrombectomy After successful recanalization, he was admitted to the neurology intensive care unit (ICU). He was discharged with a GCS score of 15, complete decrease in sensory and motor deficits and partial improvement in aphasia 96 hours after his admission to the emergency department. Afterwards, he was called for neurology outpatient clinic.

Conclusion: Stroke and traffic accidents are accepted among the major health problems world wide. Although the health problems associated with traffic accidents are mostly caused by the primary and secondary effects of trauma, the fact that accidents can occur as a result of medical conditions should be kept in mind.

References

  • Benjamin EJ, Muntner P, Alonso A et al. American Heart Association. The heart disease and stroke statistics. Circulation. 2019;139:447-54. Doi: 10.1161/CIR.0000000000000659.
  • Kolbaş F, Akça HŞ, Özdemir S et al. Ischemic stroke after head trauma in a child: case report, Int J Med Rev Case Rep. 2020; 4(4): 132-134. doi:10.5455/IJMRCR.IschemicStrokeheadtraumachildcasereport
  • Inoue T, Hitosugi M, Ooba H et al. Rate of stroke onset while driving and subsequent collision. J Stroke Cerebrovasc Dis.2018;27(9):2553-4. Doi:10.1016/j.jstrokecerebrovasdis.2018.04.029.
  • Inamasu J, Nakatsukasa M, Tomiyasu K et al. Stroke while driving: Frequency and association with automobile accidents. Int J Stroke. 2018;13(3):301-7. Doi: 10.1177/1747493017728398.
  • Büttner A, Heimpel M, Eisenmenger W. Sudden natural death 'at the wheel': a retrospective study over a 15-year time period (1982-1996). Forensic Sci Int 1999;103(2):101-12. Doi: 10.1016/s0379-0738(99)00063-8.
  • Varlık M, Eroğlu S, Özdemir S et al. Evaluation of patients who applied to the emergency department by Intra-Vehicle Traffic Accident. Fırat Med.Journal 2019;24(4):186-92.
  • Özdemir S, Ocal O, Aksel G et al. Evaluation of rhabdomyolysis patients who opted for emergency services, North Clin Istanb 2017;4(3):257-261. doi: 10.14744/nci.2017.85619.
  • Tervo T, Räty E, Sulander P et al.Sudden death at the wheel due to a disease attack. Traffic Inj Prev 2013;14(2):138-44. Doi: 10.1080/15389588.2012.695827.
  • Brodie LR, Odell M, Ranson D et al. Sudden natural death behind the wheel: Review of driver deaths and fitness to drive assessment history in Victoria, Australia 2012-2013 J Forensic Leg Med 2019;63:31-3. Doi: 10.1016/j.jflm.2019.02.011.
There are 9 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Case Report
Authors

Uğur Yasin Akgün 0000-0002-5870-1534

Hatice Şeyma Akça 0000-0003-2823-9577

Fatma Kolbaş 0000-0001-9756-5240

Serdar Özdemir 0000-0002-6186-6110

Abdullah Algın 0000-0002-9016-9701

Serkan Emre Eroğlu 0000-0002-3183-3713

Publication Date September 30, 2020
Published in Issue Year 2020 Volume: 3 Issue: 3

Cite

AMA Akgün UY, Akça HŞ, Kolbaş F, Özdemir S, Algın A, Eroğlu SE. An Unfortunate Coexistence, Ischemic Stroke While Driving. How Often? How Deadly? A Case Report. Anatolian J Emerg Med. September 2020;3(3):85-88.