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001-es BibID:BIBFORM076872
Első szerző:Árokszállási Tamás (neurológus)
Cím:Acute alcohol intoxication may cause delay in stroke treatment : case reports / ATamas Arokszallasi, Eszter Balogh, Laszlo Csiba, Istvan Fekete, Klara Fekete, Laszlo Olah
Megjegyzések:Background:The signs and symptoms of acute alcohol intoxication resemble those of vertebrobasilar stroke. Dueto their shared symptoms including double vision, nystagmus, dysarthria, and ataxia, the differential diagnosis ofalcohol intoxication and vertebrobasilar stroke may pose a challenge. Moreover, if alcohol intoxication and strokeoccur simultaneously, the signs and symptoms of stroke may be attributed to the effects of alcohol, leading todelayed stroke diagnosis and failure to perform reperfusion therapy.Case presentations:Three cases of alcohol intoxication and stroke are presented. The first patient (female, 50 yearsold) had dysarthria, nystagmus and trunk ataxia on admission. Her blood alcohol level was 2.3?.The symptomsimproved after forced diuresis, but 5.5 h later progression was observed, and the patient developed diplopia anddysphagia in addition to her initial symptoms. Angiography showed occlusion of the basilar artery. Intraarterialthrombolysis was performed. The second patient (male, 62 years old) developed diplopia, dysarthria and trunkataxia after consuming 4-units of alcohol, and his symptoms were attributed to alcohol intoxication. Two hourslater, neurological examination revealed dysphagia and mild right-sided hemiparesis, which questioned the causalrelationship between the symptoms and alcohol consumption. Cerebral CT was negative, and intravenousthrombolysis was administered. The third patient (male, 55 years old) consumed 10 units of alcohol before fallingasleep. Three hours later, his relatives tried to wake him up. He was unresponsive, which was attributed to alcoholintoxication. When he woke up 8 h later, right-sided hemiparesis and aphasia were observed, and cerebral CTalready revealed irreversible ischemic changes.Conclusions:Our cases show that alcohol consumption may interfere with stroke diagnosis by mimicking the signsand symptoms of vertebrobasilar stroke. Moreover, attributing the symptoms of stroke to alcohol intoxication maydelay stroke diagnosis resulting in failure of reperfusion therapy. Based on our observations we conclude that strokeshould be considered in the case of worsening symptoms, dysphagia, hemiparesis and disproportionately severesigns that cannot be attributed to the amount of alcohol consumed. In the case of ambiguity, ambulance shouldbe called, and if stroke cannot be excluded, specific therapy should be administered.
Tárgyszavak:Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
alcohol intoxication
thrombolytic therapy
diagnostic errors
Megjelenés:BMC Neurology. - 19 : 1 (2019), p. 1-5. -
További szerzők:Balogh Eszter (1991-) (neurológus) Csiba László (1952-) (neurológus, pszichiáter) Fekete István (1951-) (neurológus, pszichiáter) Fekete Klára (1978-) (neurológus) Oláh László (1967-) (neurológus)
Pályázati támogatás:NAP_13-1-2013-0001
NFKH-K 120042
NFKH-K 109712
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