Physician's Assistant

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Rapidreview (90 days ago 09:49)

Rapidreview Tue 06 January 2026 09:49

Last Modified: 90 days ago

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Overnight discussions held with patient's 2 sons and son-in-law at bedside regarding CT head findings which demonstrated large vessel occlusion and significant stroke.

Explained that unfortunately this is a large stroke and without treatment she is very likely to be left profoundly disabled. Condition may deteriorate further and could become life-threatening if cerebral swelling occurs (MCA syndrome).

Discussed that patient is outside the window for thrombolysis, however could potentially be within the window for thrombectomy. Explained this is a technical decision requiring specialist assessment. Family agreed for patient to be put forward for thrombectomy assessment.

Initial discussion with Derriford at approximately 02:00. Unfortunately 24/7 thrombectomy service not yet operational. Subsequently discussed with NBT Bristol who, after case review, felt that due to patient's baseline mobility (4-wheeled walker) she was not suitable for thrombectomy.

Plan made to referapatient to Derriford and consider CT perfusion scanning. Radiology registrar advised CT perfusion only available from 09:00.

Patient transferred to scanner at 09:00 for CT perfusion scan. Images sent to Derriford for assessment. Unfortunately showed too large a core in infarct and therefore not suitable for mechanical thrombectomy.

For local conservative management. Family have not yet been updated on final thrombectomy decision outcome and no family at bedside this morning.

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Rapidreview Tue 06 January 2026 09:49

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