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Stroke at high altitude diagnosed in the field using portable ultrasound

Stroke at high altitude diagnosed in the field using portable ultrasound
Stroke at high altitude diagnosed in the field using portable ultrasound
A tool that can differentiate ischemic stroke from other neurological conditions (eg, hemorrhagic stroke, high-altitude cerebral edema) in the field could enable more rapid thrombolysis when appropriate. The resources (eg, an MRI or CT scanner) to investigate stroke at high altitude may be limited, and hence a portable tool would be of benefit. Such a tool may also be of benefit in emergency departments when CT scanning is not available. We report a case of a 49-year-old man who, while climbing at 5900 m, suffered a left middle cerebral infarct. The clinical diagnosis was supported using 2D Power Doppler. The patient received aspirin and continuous transcranial Doppler was used for its potential therapeutic effects for 12 hours. The patient was then evacuated to a hospital in Kathmandu over the next 48 hours. This case report suggests that portable ultrasound could be used in the prehospital arena to enable early diagnosis of thrombotic stroke.
high altitude, stroke, ultrasound, thrombolysis, transcranial doppler, hace
1080-6032
54-57
Wilson, Mark H.
9a48b1f2-494b-42cf-a02c-c0a0e9967d33
Levett, Denny Z.
e1f97c66-51c1-4c2c-9c32-5fb96fbe93db
Dhillon, Sundeep
00137d3e-4cb6-4463-b1b9-33517d5e3e3f
Mitchell, Kay
ab96393c-c922-4125-b3f8-2ad8a6e72289
Morgan, Jon
71315ab7-5530-43ca-b3e7-e3dd028b77d6
Grocott, Michael P.W.
1e87b741-513e-4a22-be13-0f7bb344e8c2
Imray, Chris
9a0e3001-e8d6-4614-bf95-8f3fb6c6f942
Wilson, Mark H.
9a48b1f2-494b-42cf-a02c-c0a0e9967d33
Levett, Denny Z.
e1f97c66-51c1-4c2c-9c32-5fb96fbe93db
Dhillon, Sundeep
00137d3e-4cb6-4463-b1b9-33517d5e3e3f
Mitchell, Kay
ab96393c-c922-4125-b3f8-2ad8a6e72289
Morgan, Jon
71315ab7-5530-43ca-b3e7-e3dd028b77d6
Grocott, Michael P.W.
1e87b741-513e-4a22-be13-0f7bb344e8c2
Imray, Chris
9a0e3001-e8d6-4614-bf95-8f3fb6c6f942

Wilson, Mark H., Levett, Denny Z., Dhillon, Sundeep, Mitchell, Kay, Morgan, Jon, Grocott, Michael P.W. and Imray, Chris (2011) Stroke at high altitude diagnosed in the field using portable ultrasound Wilderness and Environmental Medicine, 22, (1), pp. 54-57. (doi:10.1016/j.wem.2010.10.007). (PMID:21377120).

Record type: Article

Abstract

A tool that can differentiate ischemic stroke from other neurological conditions (eg, hemorrhagic stroke, high-altitude cerebral edema) in the field could enable more rapid thrombolysis when appropriate. The resources (eg, an MRI or CT scanner) to investigate stroke at high altitude may be limited, and hence a portable tool would be of benefit. Such a tool may also be of benefit in emergency departments when CT scanning is not available. We report a case of a 49-year-old man who, while climbing at 5900 m, suffered a left middle cerebral infarct. The clinical diagnosis was supported using 2D Power Doppler. The patient received aspirin and continuous transcranial Doppler was used for its potential therapeutic effects for 12 hours. The patient was then evacuated to a hospital in Kathmandu over the next 48 hours. This case report suggests that portable ultrasound could be used in the prehospital arena to enable early diagnosis of thrombotic stroke.

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More information

Published date: March 2011
Keywords: high altitude, stroke, ultrasound, thrombolysis, transcranial doppler, hace
Organisations: Human Development & Health

Identifiers

Local EPrints ID: 348888
URI: http://eprints.soton.ac.uk/id/eprint/348888
ISSN: 1080-6032
PURE UUID: 1a42d2ed-2789-49fb-8554-f0aa058a10c5

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Date deposited: 25 Feb 2013 10:11
Last modified: 18 Jul 2017 04:46

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Contributors

Author: Mark H. Wilson
Author: Denny Z. Levett
Author: Sundeep Dhillon
Author: Kay Mitchell
Author: Jon Morgan
Author: Chris Imray

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