On the 8th of March 2024, Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia (HSAAS UPM) received a stroke patient, who is Austrian and works as a pilot with an international airline. He was in good health prior to the incident and was independent. The patient had just completed a long flight from the Maldives, a journey of 9 hours, before continuing to Kuala Lumpur International Airport (KLIA) in Malaysia. Upon landing at the airport, he experienced a sudden onset of left-sided weakness and was unable to speak. He was promptly taken to a nearby private hospital and subsequently referred to our stroke on-call team at Regional Emergency Quick Response (RESQ) Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia (HSAAS UPM) and channeled to Executive Services.

 

Upon his arrival, the patient was within a 4-5 hour window time for stroke treatment, and he underwent a clinical assessment by our neurology on-call team, Dr Azliza Ibrahim, and Dr. Firdaus. The NIHSS stroke assessment revealed that he had a moderate-to- severe stroke. Subsequent MRI scans showed hyperacute infarction in the right middle cerebral artery (MCA) and anterior cerebral artery (ACA) territories, with occlusion of the right MCA (M1 segment).

 

He underwent a cerebral angiogram, and direct mechanical thrombectomy was performed by our Neuro-Interventionalists, Dr. Mohd Fandi Al-Khafiz bin Kamis and Prof. Madya Dr.Ezamin Abdul Rahim. The procedure was successful, and the specialists managed to remove the blood clot at the M1 vessel. Following the procedure, the patient was monitored in the ICU, and repeat imaging showed sustained M1 vessel full recanalization with some mass effect (swelling), which later subsided by day 15 post-stroke.

 

 

                                                                                   

                                                                                                    Image: MRI Images before and after Thrombectomy procedure

 

 

Risk factor assessment revealed that the patient had atrial fibrillation, which was identified as the cause of the cardioembolic stroke. He was started on anticoagulation therapy to prevent recurrent strokes in the future. Patient discharged on Day 19 post-stroke. Clinical assessment prior to discharge showed improvement in his NIHSS score from 14 to 9. He regained movement in his left lower limb, and his speech returned to normal. He was then transported back to Austria via air ambulance to continue his rehabilitation therapy.

 

Image: Patient discharged and depart to KLIA via ambulance

 

Image: The patient transported back to Austria via air ambulance

 

The overall treatment was a success and we thanked the patient and spouse for choosing our medical facility through Executive Services HSAAS UPM. With Executive Services, patients are able to experience various benefits such as choosing their own preferred specialists, ward-bedroom type and save more time in receiving treatment at a reasonable price.

 

For more info on our services please contact our Executive Services team at +603-9769 9989/ exec_hsaas@upm.edu.my or log on to our website hsaas.upm.edu.my

 

Our specialists involved treating patient:

 

Neurologist: Dr Azliza Ibrahim & Prof. Dr. Hamidon Basri

Neuro-Interventionalist Dr. Mohd Fandi Al-Khafiz bin Kamis, Prof. Madya Dr. Ezamin Abdul Rahim, Prof. Dr. Ahmad Sobri Muda

Neuro-Rehab Physician - Dr. Thanalactchumy a/p Chandrabose.

 

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Note: HSAAS UPM main niche is Regional Emergency Stroke Quick Response (RESQ) unit which provide cutting edge and effective hyperacute stroke services, specifically in the medical thrombolysis and mechanical thrombectomy. These treatments can restore the blood flow to the brain quickly.

RESQ Stroke Emergency Unit operates as a front liner dedicated to stroke emergencies. Our main function is to provide swift assessment and evaluation together with the neurology, radiology as well as interventional radiology team and subsequently initiate the appropriate acute treatment. Moreover, the unit acts as the main resuscitation or stabilization area for any medical emergency that occurs within the hospital.

 

Date of Input: 05/04/2024 | Updated: 05/04/2024 | zulaikhazaharudin