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TIA Ambulance Normal CT Cerebral Infarction Hemiplegia Outcome Misrepresentation Rehabilitation Neglect Diagnostic Inaccuracy Communication Breakdown Lack of Accountability Delayed InterventionThe patient experienced a TIA. A brain CT scan performed in the emergency department was normal, and she was sent home. The following day she suffered a major cerebral infarction that resulted in permanent hemiplegia.
Permanent hemiplegia.
The head CT performed on arrival at the hospital showed no obvious abnormalities. This was the pivotal moment in the entire episode. CT scanning has limited sensitivity for detecting hyperacute cerebral infarction. The emergency physicians appear to have placed excessive reliance on a normal CT result, which led them to discharge the patient. As a result the narrow therapeutic window for effective intervention was missed, and the subsequent major stroke could not be prevented.
If contact had been made with this service at the moment the patient first reached the hospital, the permanent hemiplegia that followed could have been avoided.
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