RESUMO
Obstructive sleep apnea (OSA) is a common sleep disordered breathing in stroke patients. This case report aimed to show the presence of OSA in stroke can contribute to the increasing chance of mortality and morbidity. We presented a case of first-time stroke in a 64-year-old female with a history of pre-stroke OSA. She underwent intravenous thrombolysis as main therapy within the time limit under 4.5 hours since the stroke onset. She had prolonged hospital stay due to complications from OSA, even though she only had a small ischemic core (9 mL) in follow-up radiological imaging and was discharged with a greater National Institutes of Health Stroke Scale (NIHSS) score than admission (5 to 10). OSA can be one of warning signs for poor prognosis in stroke patients. Understanding the presence of OSA not only can be beneficial toward choosing the next steps of therapy, but also important for the rehabilitation and recovery period of stroke patients.
RESUMO
A 28-year-old man was brought to the emergency room (ER) with a history of decrease of consciousness 30 minutes before admission. In the previous 1 hour, the patient felt bitten or stabbed in the left temple area. Physical examination showed signs of N VII paresis, upper extremity motoric 3/2 (right/left) and lower extremity 3/2 (right/left), positive left extremity hypesthesia. Noncontrast MRI brain examination showed increased DWI signal intensity, suggesting diffusion restriction in bilateral centrum semiovale, bilateral posterior crus internal capsule, and bilateral corpus callosum leading to suspicion of acute-hyperacute ischemia. The therapy given while in the emergency room was IVFD asering, IV dexamethasone 5 mg, IV diphenhydramine 10 mg, oral paracetamol 500 mg, oral aspirin 80 mg, oral clopidogrel 75 mg, and oral atorvastatin 40 mg. We report a case of stroke due to an anaphylactic reaction in an effort to add to the point of view if the same case occurs.
