Middle cerebral artery stroke in chronic heart failure patient: a case report

Abstract

Middle cerebral artery (MCA) stroke describes the sudden onset of a focal neurologic deficit resulting from hemorrhagic or ischemic disruption of the MCA's blood supply. Ischemic stroke is frequently divided into several etiological categories, including atherosclerotic, cardio embolic, lacunar, and cryptogenic. Chronic heart failure (CHF) is also common cause of ischemic stroke. A 66-year-old male patient came to the emergency room at Kasih Ibu Gianyar Hospital with complaints of suddenly not being able to talk since 8 hours before entering the hospital. There is weakness on the right side of the upper extremities, and weakness on the right and left lower extremities. The patient has a history of chronic heart failure since 3 years. A thorax X-ray showed atherosclerosis. Computed tomography (CT) scan showed acute thromboembolic ischemic infarction in the left temporoparietal lobe in the left MCA territory. The causal relation between CHF and ischemic stroke represent manifestations of similar underlying risk factors, such as hypertension and diabetes mellitus. The pathophysiological mechanism of chronic heart failure can be at risk of causing a stroke infarction in large blood vessels in the brain such as the MCA, and patient MCA Stroke with CHF has high risk of recurrent stroke.