The 18-year-old female patient suffering a rare type of stroke has recovered well after ten days of intensive treatment. Photo courtesy of Military Hospital 175

The HCM City-based Military Hospital 175 has successfully treated a young female patient with a rare type of stroke.

The 18-year-old female patient was admitted to the hospital’s Emergency Department in a state of impaired consciousness, suffering severe speech disorder and inability to move the left side of her body. The stroke alert (Code Stroke) protocol was immediately activated.

After a series of data collections through clinical examinations and close clinical tests, the doctors diagnosed that the patient suffered from acute ischemic stroke in lentiform nucleus area, right hemisphere, occurring within the 24th hour due to chronic occlusion of the right middle cerebral artery by a thrombus invading from the aneurysm in the same artery.

Dr Tạ Vương Khoa, Deputy Head of the hospital’s Neurology Department, said the patient had a very large aneurysm, measuring 23x18mm, causing a stroke due to thrombus formation at the site, a rare medical case. This is the first time the hospital has encountered this type of stroke.

The doctor explained that natural thrombus formation often occurs within more than 15mm or 25mm aneurysms, with approximately 50-60 per cent cases having a partial thrombus and 13-20 per cent having a complete thrombus.

Most thrombi remain stable within the aneurysm and do not cause consequences. However, in some cases, the thrombus can be released from the aneurysm, blocking a distant cerebral artery, or it can develop, filling the aneurysm and then invading, causing ischemic stroke.

Fortunately, ischemic stroke due to distant embolism occurs in only 5-8 per cent of aneurysms with thrombi, and the occurrence due to local thrombus formation is very rare, with only a few cases mentioned in the medical literature.

Khoa said in this case, the aneurysm size was 23 x 18mm, a very large aneurysm approaching the criteria of a massive aneurysm, and the mechanism causing the stroke was thrombus formation at the site. This is a clinically rare case that the Military Hospital 175 has treated.

There have been no reports in domestic literature of similar cases.

After ten days of intensive treatment and care, the patient recovered well. She was completely conscious, her speech was almost normal, and the muscle strength on the left side of her body had significantly improved, allowing her to walk independently.

She was discharged just before Tết (Lunar New Year).

Aneurysms of cerebral arteries can occur at any age, in both adults and children. Approximately 3 per cent of the world's population has cerebral artery aneurysms, often resulting in complications such as aneurysm rupture causing a severe form of stroke with an average of one death for every three affected individuals. This is also a major cause of ischemic stroke, accounting for 80-85 per cent of all stroke types. – VNS