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Issue: Issue 3 (2016) – Supplement 2

Oral Presentation

From dissection to rehabilitation

Nelson Albuquerque, Ana Gomes, Irina Peixoto, Mário Vaz, Pedro Teixeira, Maria Carvalho, Jorge Caldas, and António Monteiro
Introduction: Stroke in young patients has been receiving higher attention recently, mostly because global stroke incidence decreased in the last three decades. Nowadays, almost 10% of ischaemic strokes occur in patients younger than 50 years. The aim of this study is to report a case of stroke with internal carotid artery (ICA) dissection in a young patient and highlight the importance of rehabilitation. 
Case report: A 41-year-old woman, with no relevant medical history, independent in the activities of daily living, was brought to the emergency room after being found lying on the floor unconscious, and having a history of throwing up and sudden headache with aura about 4 hours prior to the event. Physical examination revealed prostration (Glasgow Coma Scale of 13), right oculocephalic deviation, left hemianopsia, left central facial palsy, dysarthria and left hemiparesis. The CT scan showed a hypodensity compatible with acute ischaemic injury in the middle cerebral artery territory, or watershed regions. A CT angiography demonstrated occlusion of the right ICA with potential dissection. After 15 days of in-patient stay in the Stroke Unit, she was transferred to the Rehabilitation department to undergo an intensive rehabilitation program. She was admitted with a Functional Independence Measure (FIM) scale of 66/126, and left with 106/126. 
Conclusion: Pathogenesis of stroke in young patients is challenging. Although rare, ICA dissection remains an important cause. Its diagnosis is usually difficult and so, the incidence may be underestimated. Rehabilitation treatment plays an important role in those patients, promoting patients’ independence, social/vocational reintegration and quality of life.

Special Issue on Stroke. From the Porto University Center of Medicine Stroke Update Course, Porto, Portugal. 7–8 June 2016.

International Journal of Clinical Neurosciences and Mental Health 2016; 3(Suppl. 2):O13
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