Ho Chi Minh City Mr. Nguyen Huu Thanh (68 years old) suffered a stroke due to a blockage of a blood vessel in the important brain stem area, causing staggering and weakness in one half of his body. He was given emergency care for 30 minutes.
At 12:30 p.m. on June 20, Dr. Nguyen Thi Minh Duc (Head of the Department of Neurology, Neurology Center, Tam Anh General Hospital, Ho Chi Minh City) was having lunch when she received an urgent call from the emergency room about a suspected stroke case. A few minutes later, the doctor arrived and examined the patient, finding that the patient had a crooked mouth, slurred speech, and weakness on the right side of the body.
Relatives said they could not remember exactly when Mr. Thanh (Tan Xuan commune, Hoc Mon district) showed signs of a stroke, but guessed it was around 9am and quickly took him to the emergency room.
The hospital issued an urgent "Code Stroke" order ("red alert" for stroke emergency), prioritizing human resources and machines to save people with strokes. The patient underwent a magnetic resonance imaging (MRI). After 10 minutes, the results showed a pontine infarction, with no intracranial large vessel occlusion.
Doctor Minh Duc said that the patient's injury was located in the important brain stem area, where nerve fiber bundles going down to the spinal cord are concentrated, and where the reticular system is responsible for the human's waking and awakening functions. The patient had stroke symptoms for about 4 to 4.5 hours, although there was still a "golden" time, it could not be delayed any longer because the longer it was left, the more severe the complications would be.
Mr. Thanh was given thrombolytic drugs 30 minutes after being admitted to the hospital. Doctor Minh Duc commented that this speed is quite fast according to international standards for acute stroke emergency treatment (patients receive emergency treatment 45-60 minutes from the time they are admitted to the hospital until they are given thrombolytic drugs).
Doctor Minh Duc is examining Mr. Thanh after treatment. Photo: Provided by the hospital
Two hours later, the patient was alert, had less slurred speech, and less mouth distortion. The weakness in the right side of the body improved. After two days, the patient was able to walk, eat, drink, and had normal memory. The doctor continued to treat and stabilize blood sugar levels, used anticoagulants, and lipid-lowering drugs, and advised him to quit smoking to reduce the risk of stroke recurrence.
Mr. Thanh recounted that when he woke up that day, he did some light exercise, then took a shower and drank some coffee. Afterwards, he felt tired, and after lying down for a while, his limbs became weak on one side, he couldn't text, he dropped his phone, he had trouble speaking, and he was staggering. "When I got to the hospital, my mind was foggy, I started to feel dizzy, and thinking about it still scares me," he said.
Location of cerebral infarction in the brainstem (left) and after intervention with thrombolysis causing stroke via MRI image (right). Photo: Provided by the hospital
Mr. Thanh has a history of high blood pressure, diabetes, and has smoked for many years, having only quit smoking for over a month. These are risk factors for ischemic stroke. According to Dr. Minh Duc, smoking increases the risk of stroke by 6 times compared to non-smokers, and increases the risk of atherosclerosis. After quitting smoking for 5 years, this risk factor is reduced to the same level as that of a normal person.
Dr. Minh Duc warns that strokes in the brain stem have very diverse symptoms and in many cases are difficult to recognize, and can be diagnosed by MRI. Strokes in the brain stem can lead to many serious consequences, and delayed treatment can cause paralysis and death. Symptoms can progress rapidly within a few hours, endangering life.
Elderly people with underlying diseases such as high blood pressure, diabetes, high cholesterol, smoking... should proactively have general health check-ups and regular stroke screening. Tests, brain imaging (MRI 3 Tesla, CT 768 slices), specialized DSA angiography... can help detect abnormalities and prevent stroke early.
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