Upon arrival at Tam Anh District 7 General Clinic two hours after symptoms began, Ms. Tien's heart rate was 110 beats per minute, and her blood pressure was 160/80 mmHg. Her muscle strength in her arms and legs was 3/5 and 2/5 respectively.

Doctor of first-degree specialization Ho Ngoc Bao, an emergency medicine specialist, noted that Ms. Tien had no prior history of hypertension, diabetes, or cardiovascular diseases. After being admitted to the emergency room, her condition showed signs of self-improvement; she became more alert and could speak. According to the National Institutes of Health Stroke Scale (NIHSS), Ms. Tien's condition was rated at 3 points, indicating a mild stroke that required further monitoring.

Doctor Bao explained that cases like Ms. Tien's, where symptoms improve and the NIHSS score is low, are often mistaken for a transient ischemic attack (TIA), which typically resolves within 24 hours. However, doctors did not rule out the possibility of a progressive stroke, where symptoms might improve briefly but worsen later.

To avoid missing the ideal treatment window, the medical team activated the code stroke protocol for immediate CT and MRI scans to confirm the diagnosis. The MRI results revealed a cerebral infarction, consistent with the right-sided weakness (weakness occurs on the opposite side of the brain infarction).

MRI precisely identifies the cerebral infarction. Photo: Tam Anh District 7 General Clinic

Less than one hour after her initial self-recovery, Ms. Tien's symptoms returned, with more severe weakness in her limbs. However, since the stroke occurred within the "golden hour" (the first 4,5 hours from symptom onset), doctors administered intravenous thrombolytic medication. This treatment dissolves blood clots and restores blood flow to the brain.

15 minutes after the injection, Ms. Tien responded well; muscle strength in her right arm and leg significantly improved to 5/5. Following emergency treatment, she continued specialized monitoring at Tam Anh General Hospital in Ho Chi Minh City.

Doctor Bao (right) examines and assesses Ms. Tien's muscle strength 15 minutes after thrombolytic medication. Photo: Tam Anh General Hospital

Doctor Bao emphasized that many stroke patients miss the "golden hour" due to complacency, self-monitoring at home, or mistaking symptoms for common fatigue. He advises anyone experiencing signs such as limb weakness, facial drooping, difficulty speaking, numbness on one side of the body, or sudden dizziness to call emergency services and go immediately to a hospital capable of treating stroke.

Nhat Thanh

*Patient's name has been changed