CASE HISTORY - CASE 1

Presentation

A 64 year old woman with hypertension was admitted by her GP after complaining of right-sided weakness. Over the next couple of days her condition worsened, and four days later she appeared to suffer a serious stroke, following which she was completely unresponsive. Tests confirmed brain stem death and permission was sought to switch off her life support.

History

The woman had a 10-year history of hypertension. When she noticed loss of sensation and loss of power on her right side she went to her GP, who had her admitted.

Examination

Test results:

Progression

She showed no improvement of her right-sided weakness after admission to hospital. A small stroke was suspected, but no lesion could be seen on the CT scan. Four days after admission she deteriorated. Her Glasgow coma scale rating was 3. She was totally unresponsive. An MRI showed a suspected brain stem haemorrhage and a small established infarct in the left parietal lobe.

When tests showed brain stem death, permission was sought from her family to switch off her life support, and she died 6 days after admission.