Stroke Symptoms: When to Seek Emergency Care for Your Loved One

Q: Stroke Symptoms: When to Seek Emergency Care for Your Loved One

Hello： Please go to the emergency department as soon as possible, as there may be a peripheral artery occlusion.

Dizziness, inability to measure blood pressure in the right arm, cold fingers, and numbness and soreness in the hand?

The mother, aged 83, suffered a stroke while sleeping before the Mid-Autumn Festival.
The doctor determined that it was beyond the 3-hour window for administering thrombolytics due to her having a pacemaker, and because she was continuously extending and retracting her tongue, an MRI could not be performed.
A CT scan and vascular ultrasound revealed a blockage in the right cerebral artery.
Currently, she is unable to move her left hand, while her left foot can bend and make small movements.
Due to staffing issues related to the pandemic, she has been sent home for rehabilitation.
After 25 days at home, her right hand has been measured, but her blood pressure has not been recorded for 2-3 days.
The right hand experiences numbness and coldness in the fingers, while the left hand, which cannot move, has a blood pressure reading of 145/88.
I would like to know if it is better to wait for the doctor who is on leave to return, or if she should go to the emergency room immediately.
Should she see a cardiologist, a neurologist, or go to the emergency department?

YoYo, 40~49 year old female. Ask Date: 2022/10/04

Dr. Hong Weibin reply Neurology

Hello: Please go to the emergency department as soon as possible, as there may be a peripheral artery occlusion.

Reply Date: 2022/10/04

More Info

I'm sorry to hear about your mother's condition. It sounds like a challenging situation, and it's understandable that you're feeling concerned about her health. When it comes to stroke symptoms and the need for emergency care, there are several key points to consider.

First, it's essential to recognize the classic signs of a stroke, often summarized by the acronym FAST:
- Face drooping: Ask the person to smile. Does one side of the face droop or feel numb?
- Arm weakness: Ask the person to raise both arms. Does one arm drift downward or feel weak?
- Speech difficulty: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
- Time to call emergency services: If you observe any of these signs, it's crucial to call for emergency help immediately.

Given your mother's age and the fact that she has already experienced a stroke, any new symptoms or changes in her condition should be taken seriously. The fact that she has a pacemaker and is experiencing issues with her right side, including numbness and coldness, raises concerns that could indicate further complications, such as another stroke or other cardiovascular issues.

In your case, since you mentioned that her right hand is experiencing numbness and coldness, and considering her history of stroke, it would be prudent to seek medical attention sooner rather than later. While waiting for her doctor to return might seem reasonable, the symptoms you're describing could indicate a need for immediate evaluation.
You should consider going to the emergency department (ED) rather than waiting. The ED can provide a comprehensive assessment and determine whether she needs to be admitted for further treatment. Given her history, they may perform imaging studies like a CT scan or MRI to assess for any new strokes or other complications.
Regarding which department to visit, the emergency department is the best choice in this situation. They can evaluate her symptoms and decide whether she needs to see a neurologist or a cardiologist based on their findings.
It's also important to monitor her vital signs, especially her blood pressure, as fluctuations can indicate underlying issues. If her blood pressure readings are consistently abnormal, this could be a sign of a serious condition that needs to be addressed immediately.

In summary, given your mother's history of stroke and the new symptoms she's experiencing, it would be wise to seek emergency care as soon as possible. The emergency department can provide the necessary evaluations and interventions to ensure her safety and health. Don't hesitate to advocate for her care, as timely intervention can significantly impact outcomes in stroke patients.

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