Managing two strokes at once

2 october 2017 – 13:30

Stroke Recorded Case – Expert Panel & Participants Discussion: Gui de Chauliac University Hospital, Montpellier, France
Team led by Vincent Costalat
 
A massive stroke (NIHSS score of 19 with an M1 occlusion) in a rural area 200 km from a comprehensive stroke center (CSS) and 50 km from the nearest primary/ IV tPA hospital center. Do you consider time or distance? Helicopter or ambulance? And the two hospitals themselves, how efficient are they in entry to treatment times? Will the ongoing RACECAT trial shed light on these questions? Join moderator T. G. Jovin with expert panelists, R. Blanc, P. Brouwer, F. Dolveck, J. Gralla, B. Lapergue and W. Taylor as they discuss a challenging series of cases presented by V. Costalat.
Follow the first patient, who was administered IV tPA in the primary hospital, as he is transferred by helicopter to the CSS, where he is seen to be dramatically improving (NIHSS score of 9, over 200 minutes after first symptoms).
What would you do next? He still has an NIHSS of 9? Especially, when a second stroke patient, already in the ACC, who entered the day before with stroke symptoms (NIHSS score 6) begins to deteriorate and there is only a single angio suite available to treat the two patients.
How would you clinically manage this challenging situation? Join the discussion now…