Case Study/Discussion - 030916Created by:
An 65 years old gentleman, background history of ischeamic heart disease (with coronary stent in situ), hypercholesterolemia, hypertension, was admitted to hospital due to sudden onset of left upper limb, left lower limb weakness with some slurred speech, lasting for around 30 minutes, with spontaneuos recovery. The symptoms was started when patient was eating his lunch, and felt sudenlly his left upper and lower limbs became very weak, and unable to stand up steadily. The wife noted his speech was slightly slurred as well. Ambulance was called to brought him to casualty. His symptoms was fully resolved when arrival to hospital. His neuroloy examination was all entirely normal, with no focal neurological defect. ECG showed sinus rthym. CT-Brain done showed no acute abnormality. But, CT-angiogram showed aound 80%-90% stenoisis of his righ internal carotid artery. What is your diagnosis ?? What is the important managemen plan for him??