Improvement of cerebral perfusion in hemodynamic stroke patients after carotid stenting: Clinical, cerebral TCD, and cerebral DSA evaluations

Taurus Laisari; Achmad Firdaus Sani; Sita Setyowatie

doi:10.53730/ijhs.v6nS1.5330

Authors

Taurus Laisari Resident of Neurology Department, Faculty of Medicine, Universitas Airlangga Surabaya/Soetomo General Hospital Surabaya, Indonesia
Achmad Firdaus Sani
achmad_sani@yahoo.co.id
Department of Neurology, Faculty of Medicinel, Universitas Airlangga Surabaya/Soetomo General Hospital Surabaya, Indonesia
Sita Setyowatie Department of Neurology, Airlangga University Hospital Surabaya, Indonesia

Keywords:

Hemodynamic stroke, hypoperfusion, carotid artery stenting

Abstract

Hemodynamic stroke is caused by hypoperfusion, instead of infarction or embolism, with a prevalence of approximately 10% of all cerebral infarctions. Introducing hypoperfusion as the causative factor for ischemic stroke is crucial in patient care and management. It can be demonstrated through clinical symptoms, physical examination, and diagnostic imaging. Transcranial Doppler (TCD) and Digital Subtraction Angiography (DSA) examinations to determine cerebral blood flow are very helpful in assessing cerebral perfusion improvement in hemodynamic stroke. A 49-year-old male patient complained of sudden weakness in the right half of the body after waking up, accompanied by a headache and communication difficulties. He also experienced weakness of the right upper and lower limb 1 week before hospital admission and improved 10 hours afterward. The results of the physical examination indicated differences in right and left arm systolic blood pressure of more than 20 mmHg, severe dysarthria, central right facial and lingual palsy, right hemiparesis, and right hemihypesthesia. The results of the CT scan of the head without contrast revealed a subacute cerebral ischemia infarct in the cortical/subcortical left parietal lobe.

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